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Historical empathy, guns, and the strict construction of the US Constitution
I am sick at heart. This is hard stuff. All those kids. Teachers and principals, too, dying trying to defend the children. Everyone cute as button. Just as bad, I have to re-publish this article, since the needed breakthrough has not yet occurred. What to do about it? My proposal is to expand historical empathy. Really. Historical empathy is missing, and if we get some, expand it, something significant will shift.
Putting ourselves in the situation of people who lived years ago in a different historical place and time is a challenge to our empathy. It requires historical empathy. How do we get “our heads around” a world that was fundamentally different than our own? It is time – past time – to expand our historical empathy (Kohut 2020). For example …
Brown Bess, Single Shot Musket, standard with the British Army and American Colonies 1787
When the framers of the US Constitution developed the Bill of Rights, the “arms” named in the Second Amendment’s “right to keep and bear arms” referred to a single shot musket using black powder and lead ball as a bullet. The intention of the authors was to use such weapons for hunting, self-defense, arming the nascent US Armed Forces, and so on. No problem there. All the purposes are valid and lawful.
One thing is for sure and my historical empathy strongly indicates: Whatever the Founding Fathers intended with the Second Amendment, they did NOT intend: Sandy Hook. They did not intend Uvalde, Parkland, Columbine, Buffalo, NY, Tops Friendly. They did not intend some 119 school shootings since 2018. They did not intend a “a fair fight” between bad guys with automatic weapons and police with automatic weapons. The Founding Fathers did not intend wiping out a 4th grade class using automatic weapon(s). They did not intend heart breaking murder of innocent people, including children, everyone as cute as a button.
Now take a step back. I believe we should read the US Constitution literally on this point about the right to “keep and bear” a single shot musket using black powder and lead ball. The whole point of the “strict constructionist” approach – the approach of the distinguished, now late Supreme Court Justice Antonin Scalia, who passed away on Feb 13, 2016 – is to understand what the original framers of the Constitution had in mind at the time the document was drawn up and be true to that intention in so far as one can put oneself in their place. While this can be constraining, it can also be liberating.
Consider: No one in 1787 – or even 1950 – could have imagined that the fire power of an entire regiment would be placed in the hands of single individual with a single long gun able to deliver dozens of shots a minute with rapid reload ammo clips. (I will not debate semi-automatic versus automatic – the mass killer in LasVegas had an easy modification to turn a semi-automatic into an automatic.)
Unimaginable. Not even on the table.
This puts the “right” to “bear arms” in an entirely new context. You have got a right to a single shot musket, powder and ball. You have got a right to a single shot every two minutes, not ten rounds a second for minutes on end, or until the SWAT team arrives. The Founding Fathers did not intend the would-be killer being perversely self-expressed on social media to “out gun” school security staff who are equipped with a six shooter. Now the damage done by such a weapon as the Brown Bess should not be under-estimated. Yet the ability to cause mass casualties is strictly limited by the relatively slow process of reloading.
The Founding Fathers were in favor of self-defense, not in favor of causing mass casualties to make a point in the media. The intention of the Second Amendment is to be secure as one builds a farm in the western wilderness, not wipe out a 4th grade class. I think you can see where this is going.
Let us try a thought experiment. You know, how in Physics 101, you imagine taking a ride on a beam of light? I propose a thought experiment based on historical empathy: Issue every qualified citizen a brown bess musket, powder, and ball. What next?
Exactly what we are doing now! Okay, bang away guys. This is not funny – and yet, in a way, it is. A prospective SNL cold open? When the smoke clears, there is indeed damage, but it is orders of magnitude less than a single military style assault rifle weapon. When the smoke clears, all-too-often weapons are found to be in the hands of people who should not be allowed to touch them – the mentally unstable, those entangled in the criminal justice system, and those lacking in the training needed to use firearms safely.
More to the point, this argument needs to be better known in state legislatures, Congress, and the Supreme Court. All of a sudden the strict constructionists are sounding more “loose” and the “loose” constructionist, more strict. It would be a conversation worth having.
The larger question is what is the relationship between arbitrary advances in technology and the US Constitution. The short answer? Technology is supposed to be value neutral – one can use a hammer to build a house and take shelter from the elements or to bludgeon your innocent neighbor. However, technology also famously has unanticipated consequences. In the 1950s, nuclear power seemed like a good idea – “free” energy from splitting the atom. But then what to do with the radioactive waste whose half life makes the landscape uninhabitable by humans for 10,000 years? Hmmm – hadn’t thought about that. What to do about human error – Three Mile Island? And what to do about human stupidity – Chernobyl? What to do about unanticipated consequences? Mass casualty weapons in the hands of people intent on doing harm? But wait: guns do not kill people; people with guns kill people. Okay, fine.
There are many points to debate. For example, guns are a public health issue: getting shot is bad for a person’s health and well-being. Some citizens have a right to own guns; but all citizens have a right not to get shot. People who may hurt themselves or other people should be prevented from getting access to firearms. There are many public health – and mental health – implications, which will not be resolved here. There are a lot of gun murders in Chicago – including some using guns easily obtained in Texas and related geographies. The point is not to point fingers, though that may be inevitable. The guidance is: Do not ask what is wrong – rather ask what is missing, the availability of which would make a positive different. In this case, one important thing that is missing is historical empathy.
Because the consequences of human actions – including technological innovation – often escape from us, it is necessary to consider processes for managing the technology, providing oversight – in short, regulation. Regulation based on historical empathy. Gun regulation . Do it now.
That said, I am not serious about distributing a musket and powder and ball to every qualified citizen in place of (semi) automatic weapons – this is an argument called a “reduction to absurdity”; but I’ll bet the Founding Fathers would see merit in the approach. There’s a lot more to be said about this – and about historical empathy – but in the meantime, I see a varmint coming round the bend – pass me my brown bess!
Additional Reading
Thomas Kohut. (2020). Empathy and the Historical Understanding of the Human Past. London: Routledge.
PS Please send a copy of this editorial to your US Congressional representatives in the House and Sensate.
Radical empathy, the double bind, and moral trauma
A narrative is not a substitute for a philosophical argument; nor is a philosophical argument a substitute for a story. These are not substitutable for one another under descriptions that preserve truth. The matter is especially tricky if one is making a point or taking a position about human actions, preferences, or behavior in extreme situations. One can make a point or support a position by means of a logical argument. In an argument, one considers the relationship between the premises of the argument and the conclusion. Are the premises factually accurate? One interviews witnesses or assesses the available data. One can have an invalid argument from true premises. The premises are true but the conclusion does not follow from them. One can have a valid argument from false premises. The premises are false but the conclusion logically follows from them. Or one can have a conclusion that validly follows from true premises, in which case the argument is sound, the gold standard of reasoning. Once an argument contains a contradiction, then anything follows from it, including a true conclusion. It is just that the latter is logically unrelated to what comes before. And arguments are only getting started here. If one is dealing with a moral dilemma or nonstandard logics such as possible world scenarios, the premises become more complex, the technicalities fan out, and the alternative paths through the labyrinth of reasoning multiply rapidly. While human actions are sensibly understood to have both reasons and causes, these are taken to include motives and triggers that may be redescribed as “insane,” “deviant,” “anomalous,” “pathological,” and so on. Special cases, exceptions, and examples that are counter-intuitive, raise the spectrum that one is dealing with a phenomena that is not always a rational process.
Thus, one looks for alternative ways of making one’s case than marshalling the technical apparatus of formal and informal logic. One can make a point or support a position by telling a story. One trades off logical rigor in favor of a compelling narrative. “Let me tell ya what happened.” “You can’t make this stuff up!” “You are not gonna believe what he told her!” Without deciding whether or not reason is the slave of the passions (Hume 1739), storytelling exemplifies the struggles in which people engage in an attempt to attain personal satisfaction and fulfillment in the face of the conflict requirements of scarce reality, community standards, and earning one’s daily bread by the sweat of one’s brow, even if the sweat is due to the stress of working in a corporate empathy desert rather than plowing the field in the hot sun. [1]
For example, Paul Tremblay’s novel The Cabin at the End of the World (2019) presents a narrative that, in its outline, is similar to the overall structure of the moral dilemma known as “the Trolley Car Dilemma.” Before defining the terms of the story and of the philosophic dilemma in detail, it is useful to note, both offer rich possibilities for confronting human behavior and actions in extreme situations. Both offer possibilities for the practice of moral reasoning and of the practice of empathy. But only one put the reader and reasoner in the trolley car itself, facing the dilemma, and that, counter-intuitively is not the abstract statement of the dilemma in the trolley car problem, but the novel itself. (For details on the movie version of the novel see the New York Times Review.[2])
The story delivers the experiences of being caught in a double bind, moral trauma, soul murder, and cognitive-emotional-moral conflicts that make people so anxious they up at night unable to sleep due to intrusive thoughts. With the story, one is inside the experience of the dilemma in the sense of being viscerally gripped by it in way that is not the case if one is abstractly reasoning cognitively about motives and morals. With the story, one is grabbed by the throat, and is hard pressed to pretend that the dilemma does not matter. This matter of mattering is of the essence here. With the story, the dilemma is no longer able to be dismissed as a puzzling case or an irrelevant philosophical game without real world relevance. But the “mattering” here is not in the interest of expanding knowledge by confirming or refuting a quantitative hypothesis – that five people are more people than one person. The mattering is in order to get to one’s friend’s house in one piece – literally to go on being. Well-being. Personal flourishing. Survival.
That is different than being up at night because one is trying to disentangle a logical puzzle, the difference being roughly that between an obsessive preoccupation and post-traumatic stress. Neither is pleasant and both have the potential to keep one up at night. Though many exceptions exist and generalization is risky, treatment of the former is considered more predictable and simpler.
The Trolley Car dilemma is as follows. You are the agent on a runaway trolley car with broken brakes, which will run over five people unless you throw the switch to change the track, which, however, will result in running over one person. So far, everyone, including you, are innocent. Surely this is an engaging thought experiment, a philosophical fiction.
Our empathy for the agent starts out as requiring a decision that no one should have to make. The agent is forced to make a decision that neither he nor anyone else is authorized to make. But he has to make it anyway. Doing nothing is also a decision, and people are going to die. This is the definition of a double bind – damned if one does, and damned if one doesn’t. This is the kind of thing that drives people insane – insane with second guessing, insane with grief, insane with guilt. One can be both a perpetrator and a victim.
The problem of course is unsolvable without further background. When the philosophers Philippa Foot (1967) and Judith Jarvis Thompson (1976) first proposed a version of it, Foot wanted to present the dilemma as the difference between the utilitarian moralists such as Jeremy Bentham, committed to the greatest good of the greatest number, and the deontologists roughly represented by Immanuel Kant, for whom the motive for acting is itself the guide to the moral worth of the behavior in question. The solution is relatively easy for the utilitarian – save the greatest number. The utilitarian then must deal with the fact that the person who throws the switch becomes a perpetrator, killing the one innocent person. The Kantian is clear that the moral worth of an action is independent of the consequences of the action, which, in this life, are often unpredictable even when the outcome seems certain. The moral law does not allow throwing a switch in order to kill one person. The Kantian, casuistically inspired by Thomas Aquinas (see two paragraphs below), might argue back that the moral law does indeed allow throwing a switch to save five people. Or at least it does not prohibit one from saving five people, the motive being to preserve and further life. The casuistry is that one must turn a blind eye to the consequence of killing the one person, which for the Kantian is relatively easy to do because he excludes consequences from the moral equation. The consequence of killing the one person is entirely a regrettable accident. However, the person who throws the switch becomes a perpetrator nonetheless, killing the one innocent person.
Radical empathy reveals that one can be both a perpetrator and a survivor. What has been overlooked is the role of moral trauma. The driver of the trolly car, the agent, is put in a double-bind, in which, whatever the action, innocent people are going to suffer and die. In literature this has a name. It is called “tragedy.”
Radical empathy reveals the tragic dimension of the situation. The Trolley Car dilemma requires a story to complete it, and the story is an empathic, albeit, tragic one. Here “completion” does not mean that no one dies. It means that a person is forced to make a decision that no person is authorized to make – that no one should have to make – but one has to make it anyway. Doing nothing is the decision to let five die. Throwing the switch is intentionally to embrace the role of perpetrator and give up the illusion that one is innocent. Indeed in some jurisdictions, throwing the switch would technically qualify for manslaughter. Let the jury decide whether voluntary or not.
Nor is this merely the principle of double effect reasoning, in which a valid action has a harmful “side effect” as “collateral damage,” which Thomas Aquinas documented in Summa Theologica (Part 2 of II, Question 64, Article 7), his example being killing an aggressor in self-defense. There are no “bad guys” in the Trolley Car Dilemma. A closer analogue, probably known to Foot, would be the example of childbirth before modern medicine made a Caesarian Section a relatively safe, albeit radical, intervention. (Reader (trigger) alert: this not for the faint of heart.) A viable baby is backwards or badly positioned in the womb, and the baby is stuck. If one saves the mother, she may eventually give birth to five more sons and daughters. If one saves the baby, by performing the Caesarian, then the mother will bleed to death (probability .95). Action is required. The surgeon is the agent in the trolley car. If the surgeon does nothing, the baby dies, still in the womb; and the mother subsequently dies, probably of infection. One option is the surgeon decides to act to remove the stuck baby, usually by performing a craniotomy, cutting it apart. Technically speaking, when the baby’s head is crushed that is child abuse, soul murder. The alternative is to operate on the mother. The outcome was fatal to her at least up until the 1940s. The surgeon is both the perpetrator and the survivor in that he must grapple with moral trauma, the latter in the sense that he must live with the guilt that is experienced for killing the otherwise innocent, viable baby.
Childbirth is not war, though given the paragraph before last it may seem so. Moral trauma is common in war, though until recently it has not been recognized by the United States Veteran’s Administration as a cause of the mental health issues of “wounded warriors.” For example, in Iraq, a car is racing towards a security check point and fails to stop even after hand signals and warning shots. Believing the car to be a suicide bomb, the sergeant orders the corporeal to shoot at the driver – with a 50-caliber machine gun. It turns out to be a family racing to the hospital because the pregnant mother has gone into labor. The survivors are awarded $10K and an apology (Carlstrom 2010). The soldier who pulled the trigger is both a perpetrator and now trying to survive moral trauma. He is uninjured physically. He was a “normal” midwestern guy with brother and sisters and a pregnant wife of his own. The army does not debrief the team about what happened. He is not invited to talk about it. He really did pull the trigger, believing he was following a valid military order and defending his team against a suicide bomber. But, examining the car afterwards, and realizing what he and his team have done, he sinks back into himself, burdened by guilt at having killed the family. He becomes unresponsive to those around him, does not respond to orders, and is shipped back home without being debriefed and with a dishonorable discharge. He is no more responsive back in the States, and, does not want to talk about it. His marriage fails. He becomes homeless. A perpetrator in the technical sense, but also a victim and survivor.
Thus, the Trolley Car Dilemma is unsolvable without a corresponding story. In the story, “you” are there. You are there at the nonfunctioning controls. The track is racing towards one at high speed. The innocent persons come rapidly into view. You search desperately for an ax, a fire extinguisher, a suitcase to throw under the rapidly rotating wheels. None is available. You wish you had the courage for altruistic suicide, throwing yourself in front of the racing car to attempt derailment. One thought too many for effective action. You invoke the deity, say a prayer, call on God. He is busy elsewhere. No one is listening. You are in a double bind. Like Colonel Aureliano Buendia facing the firing squad, you cannot move. You can decide what to shout, but you have no control over the “Ready, aim, fire!” The “solution” is a story called “tragedy.” This is what tragedy feels like, looks like, sounds like. The solution is a tragedy.
The story “completes” the problem in the sense of showing how every action designed to avoid the tragic outcome (that innocence suffers and dies) advances the action in the direction of a tragic outcome – innocence suffers and dies. The agent who pretends to be innocent by taking no action becomes a perpetrator and descends into trying to live with and survive moral trauma; and the agent who embraces action becomes a perpetrator and descends into trying to live with and survive moral trauma.
Because the consequences of human action both escape us and, as in this case, are inescapable, radical empathy teaches that people are forced to make decisions that they should not have to make and must live with the moral trauma as survivors. Of course the example of the seemingly inevitable outcome is a counter-example as Colonel Aurelian Buendia faces the firing squad, as readers of Marquez know well, a revolution occurs and the execution is interrupted seconds before the order to “Fire!” is given. Buendia lives for another two hundred pages. So our finitude consists in knowing that “no one gets out alive,” but also that we do not know what the future will bring, the details of even the next few seconds, or the timing of the exit in spite of being so certain.
Radical empathy is defined formally in relation to standard empathy: Radical empathy deploys the same four minimal essential aspects of standard empathy – receptivity, understanding, interpretation, and responsiveness. The differences from standard empathy map to these dimensions. Empathic receptivity is “dialed down,” decreased to prevent empathic distress or compassion fatigue. “Dialed down” does not mean the listener becomes hard-hearted or unfeeling, but the vicarious aspect of the survivor’s experience is emphasized. The listener is aware that this trauma or tragedy is indeed a trauma or tragedy, but, for example, the listener is not on the Titanic, but watching the movie. (key term: vicarious experience.) The empathic understanding of possibility is radicalized in the sense that possibilities of the experience of pain, suffering, or high spirits exist that the listener’s imagination cannot necessarily grasp in advance. For example, in the Mephistopheles’ description of Hell in Mann’s Dr Faustus, words are used to described the indescribable;
Every compassion, every grace, every sparing, every last trace of consideration for the incredulous, imploring objection ‘that you verily cannot do so unto a soul’: it is done, it happens, and indeed without being called to any reckoning in words; in soundless cellar, far down beneath God’s hearing […] (1947: 245)
Empathic understanding of possibility confronts the survivor, who may indeed be skeptical that anything can make a difference, with the assertion. “No one was listening when you called for help – well, someone is now listening. Try me. Recovery is a possibility, skeptical though you, the survivor, may be.” If empathic receptivity is “dialed down,” empathic interpretation is “dialed up,” expanded. The folk definition of “taking a walk in the Other’s shoes” is most relevant in cognitively trying to imagine what the Other had to go through when the listener’s sense of the situation is limited. When the listener’s empathy gets “stuck,” blocked, inhibited, because the experiences of the self and the Other are so at variation, empathic interpretation, perspective shifting, is a proven way of cognitively “jump starting” the empathic process. Finally, the empathic responsiveness of radical empathy consists in eliciting an expression of the experience of the trauma from the survivor in the present situation of safety, acceptance, and toleration; processing that experience to the extent that it can be processed to drain the toxic emotions out of the trauma, defanging the snake, so to speak, to the extent that is possible; and saying what happened, thus, giving the survivor’s experience back to the survivor in a form of words that acknowledges and recognizes the survivor’s humanity.
[1] Plato dialogues are rich in logical reasoning about distinctions of meaning and they sometimes end up with a myth. When reasoning comes to an end, the dialectic changes from persuasion by logic into storytelling, which provides a different kind of persuasive engagement. For example, Plato’s Republic ends with the myth of Er (10.614–10.621); the Phaedrus ends with the myth of the winged soul; and the Timaeus includes a myth of the creation of the universe by a demiurge
[2] https://www.nytimes.com/2023/02/02/movies/knock-at-the-cabin-review.html?searchResultPosition=2
NOTE: This is an excerpt from a forthcoming book, Empathy in the Context of Literature (c) Lou Agosta, PhD
This post, web site, and all content (c) Lou Agosta, PhD
Top Ten Empathy Trends for 2023
Empathy is a practice and priority, not a mere psychological mechanism. Practicing empathy is a way of being in the world, creating a safe space of openness, acceptance and toleration. In the face of a contagion of Omicron, we need a contagion of empathy. Empathy is contagious. This is a condition you actually want to share with someone else, especially someone who seems to need some empathy – all the while being clear to set firm boundaries against bullying, delusional thinking, and compassion fatigue. Keep in mind this list is a top ten “count down,” so if you want to know what is #1, fast forward to the bottom.
Here are my choices and predictions for the top ten trends in empathy for the year 2023.
10 – Empathy for the jurors in the trial of the century. The prediction is that Mr T will stick to his story – “we was robbed” – even after he is indicated, believing there is no such thing as bad publicity. The prospective defendant is innocent until proven guilty and so on. However, it is noteable that a former-NSA analyst was sentenced to nine years in prison in July 2019 for hoarding official documents [https://www.nextgov.com/cybersecurity/2019/07/ex-nsa-contractor-serve-9-years-hoarding-classified-information/158564/]. This seems open and shut. Nevertheless, this trend is about the jurors and not the defendant. This promises to be a long, headline-grabbing trial, and the jury will have to be sequestered, cut off from news, and, subjected to a lot of legal jargon. Being without Facebook and Twitter and other
is. While the challenges of finding an unbiased jury are not trivial, all that is needed for a fair trial are twelve people who are willing to set aside their opinions and look at the facts from the point of view of the law as defined for them by the presiding judge. That sounds like creating a space for critical thinking and taking multiple points of view, the latter the folk definition of empathy.
9 – Empathy in time of war becomes Red Team not kindness. All the empathy in the world is not going to help anyone if one country invades another with a list of intellectuals, business people, and politicians to be arrested and killed. That noted, the need for helping, compassion, and good works of all kinds is still on the critical path to building a better world. Yet in time of war or threat of war, the power of empathy consists in putting oneself in the shoes of the opponent, thinking like the opponent, and thereby anticipating and thwarting the opponent’s moves. Putting oneself in the opponent’s shoes requires taking off one’s own shoes first. Never underestimate the power of empathy – never – yet empathy does not work very well with psychopaths, bullies, totalitarian dictators, and the criminally insane. Many of these individuals will take the affective, bottom up empathy and use it against you. Therefore, empathic engagement must be limited to cognitive empathy – use critical thinking to try to figure out what the Other is thinking and feeling in order to intervene in a way that is useful according the standards of a humane community.
8 – Elon “44 billion up in smoke” Musk gets empathy for his employees, customers, and stakeholders. And if you believe prediction, then I have a bridge in Brooklyn that I would like to sell to you. The empathic truth of this admittedly cynical prediction is that many of the things that make a person good at business make him or her relatively poor empathizers. Business leaders lose contact with what clients and consumers are experiencing as the leaders get entangled in innovating the technologies in new products and services, solving legal issues, reacting to the competition, or implementing the software required to sustain operations. Yet empathy is the ultimate Capitalist Tool. Empathy is on the critical path for serving customers, segmenting markets, positioning products (and substitutes), taking the perspective of the competition [not exactly empathy but close enough?], building teams and being a leader who actually has followers. Saying that the purpose of business is to make money is like saying the purpose of life is to breathe. Definitely do not stop breathing. The purpose of business is to deliver value and satisfaction to customers. Then the revenue shows up. When the ontology of empathy exposes it as the foundation of community, then expanding empathy becomes nearly synonymous with expanding business. For example, building customer communities, building stakeholder communities, team building, are the basis for brand loyalty, employee commitment, and sustained or growing market share. Can revenue be far behind? Sometimes leaders don’t need more data, we need expanded empathy, though ultimately both are on the path to satisfied buyers, employees, and stakeholders. “CEO” no longer means “Chief Executive Officer,” but “Chief Empathy Officer.” This time one can hear the groans—from the executive suite, not the cubicles.:
Listen on Spotify: https://open.spotify.com/show/6nngUdemxAnCd2B2wfw6Q6 Empathy is one of those things that are hard to delegate. This role shows up like another job responsibility with which the CEO of the organization is tasked—along with everything else that she already has to do. As if she did not already have enough alligators snapping at various parts of her anatomy, one has to be nice about it, too? But of course empathy is not niceness, though it is not about being un-nice. It is about knowing what others are experiencing, because one has a vicarious experience and then processing that further to expand boundaries and exercise leadership.
7 – Etiquette Gurus and celebrity life coaches go back to school to learn empathy. The latest poster child for this trend is Sara Jane Ho, who reportedly broke up with her boyfriend of four years over text, and rationalizes it with a meme about context, in which the context sounded like she was busy making a Netflix show. This is right up there with trend #8, getting fired by a Twitter tweet. The context, according to the author of the article, Maureen O’Connor, was that Ms Ho’s eyes were getting puffy from crying, and she would not “look good” on her Netflix show. Empathy is a high bar and one does not get there every day. If Ms Ho’s resume is to be believed, she is a graduate of Phillips Exeter Academy, Georgetown, Harvard (attended), and now a Netflix sensation. One speculates that she is a survivor of a Tiger Mom or Bootcamp Dad (or both), and may herself benefit from getting a good listening at the side of a committed mentor. Based on the review of Ms Ho’s project by Maureen O’Connor [ https://www.nytimes.com/2023/01/02/style/sara-jane-ho-mind-your-matters.html], she (Ms Ho) exemplifies the kind of etiquette which is a disguised application of sadism, hostility, aggression, and one-upmanship. While I do not know the details and maybe I am missing the humor, but so far, all these people are easy to dislike. You go to take off your coat and you can’t because there is a knife in your back. There is nothing wrong – but something is definitely missing – empathy.
6 – Empathy is a practice not a mere psychological mechanism. Empathy is the practice of authentically relating to the other person. The practice of empathy is a way of being – being with and in relation with others. Many of the misunderstandings of empathy – especially in the form of compassion, pity, emotional contagion – can be traced to treating the practice of empathy merely as a psychological mechanism. There is nothing wrong with this as such. However, what gets missed is the relational quality of empathy. Drive out bullying, hostility, aggression, bad language, and empathy naturally comes forth. People want to be empathic if given half a chance.
5 – Empathy expands for the True Believer, but not agreement with the conspiracy or delusion. The criteria for identifying the True Believer is he or she doubles down. When the space does not arrive from Alpha Centauri – or your candidate does not win – the True Believer does not say, “I might have been mistaken and maybe I need to look at my assumptions or inquire into other scenarios.” The True Believer doubles down – “We was robbed!” “We will catch the next space ship!” It does no good – none – to disagree with the True Believer or to argue or reason, because the delusion or conspiracy theory is holding together the True Believer’s personality. To give up the delusion would be to give up the personality, to risk the disintegration of who the person is. What to do about it? Teach critical thinking. Both empathy and critical thinking create a space of acceptance and tolerance in the context of which the power of the delusion starts to shrink. More on this in the next trend.
4 – Empathy and critical thinking form an alliance. It is a bold statement of the obvious that the ongoing breakdown in community standards bodes ill for a cultural and political and public conversation context in which disputants engage in near delusional disagreement on basic quantitative facts such as the rules of etiquette, basic science such as the biology of vaccinations, gender distinction (or not), the basic results of elections, and so on. Though it is not a quick solution, it is hard to think of a better one: teach skills in critical thinking such as assessing facts against sources, evaluating the reliability of sources, reporters, informants, and so on, against prior performance, checking validity and logic of arguments, and engaging enlarged thinking in taking the point of view of the other person, especially if the person (or group) disagrees with one. (See Jonathan Haber, (2020), Critical Thinking. Cambridge, MA: The MIT Press.) Taking different points of view, of course, is the basic folk definition of empathy. But do not forget to take off one’s own shoes before trying on the other’s or one will get projection, not empathy.
3 – Translation replaces projection as the underlying model for empathy. “Translation” as in translating between languages or between different artistic media or different signaling systems. In short, psychologism – psychology in the negative sense – is replaced by the linguistic speech act of translating the other person’s experience into one’s own and then giving it back (empathically) to the other. This paradigm of empathy as translation is arguably at the same level of generality as empathy as projection, but remained undeveloped until the rise of hermeneutics along a separate trajectory. The modern innovators of interpersonal empathy such as Carl Rogers (1902–1987) might be read as leap-frogging back to the original sense of entering the other’s world in order to translate it into the first person, subject’s own terms. The translation model of empathy (credited to Johann Herder (1744 – 1803) of whom one rarely hears today) also fits well with what Gordon Allport (1897–1967) and Kenneth Clark (1903–1983) were doing in arraying empathy against racism and prejudice in expanding the boundaries of community by empathically translating between them. An entire possible alternate history of empathy, as yet unwritten, opens up at this point – empathy as translation between persons.
2 – Empathy for the Amazon rain forest grows and reaches a critical mass, but will its critical mass be enough or too late to overtake the “critical mass” of green house gases. The challenge is that global warming does not live like an actual possibility for most people, who cannot imagine such an outcome – for example, just as in December 2019 no one could envision the 2020 global pandemic. Empathy is oxygen for the soul. If the human psyche does not get empathy, it suffocates. Climate changes makes this metaphor actual. If humanity does not drown as the massive Greenland and Antarctic ice sheaths slide into the oceans, humans will suffocate as the levels of green house gases and heat overwhelm temperate habitats. There is no Planet B.Empathy is a bridge: The bridge between the gridlocked present and a seemingly impossible-to-imagine future is empathy. The empathic moment is an act of imagination. That is the interesting thing about empathy. It may seem like a dream; but the dream lives. It is inclusive. Lots more work needs to be done on this connection. For purposes of this list of predictions, this “shout out” will have to suffice. For specific actionable recommendations, see David Attenborough’s A Life on Our Planet, now streaming on Netflix: https://www.netflix.com/title/80216393
2a – Vaccine deniers get empathy and say: “Oh, I wish I were already experiencing the minor side effects of the latest booster shot instead of systemic organ breakdown!” People get the latest booster against Covid, parents get their children the measles and polio and other shots the children need for school, which gets into people’s arms at an accelerating rate. Vaccine deniers get empathy and say: “Oh, I wish I were already experiencing the minor side effects of the latest booster shot instead of systemic organ breakdown!” Biological science continues to produce small, medium, and large “miracles,” even as basic health care services for citizen’s struggle. People become medical doctors and nurses and enter the healthcare field because they want to make a difference. They experience an empathic calling to intervene to reduce the pain and suffering in the world. Then these same people get caught up in the faceless, unempathic bureaucracy of a healthcare system where capitation means doctors have to see an unworkable number of patients a day – four an hour for eight hours. Using empathy and medical ethics, the doctors push back saying: “I am required by medical ethics to spend as much time with the patient as is needed to get the patient the medical treatment they require – and are entitled to be paid for it.
2b – Men lead from empathy in the struggle against domestic violence (DV). When powerful men such as Bezos, Musk, Ellison, Gates, Biden, Milley, clean up their failures of leadership and take action saying “Violence against women anywhere – home or work or anywhere – is unacceptable and here are the resources for intervention,” then a breakthrough will occur. Men will find their voice and speak out even more loudly and provide leadership against domestic violence to those of their own gender who just do not get it.
While women have provided the leadership and will continue to do so, powerful men must step up and provide guidance to their fellows about proper boundaries and respect for them in relationships. This is ongoing. What is new: powerful men step up and speak out and provide leadership among men in establishing respect for boundaries in creating communication, affection, and affinity.
For data- and empathy-based innovations that have occurred in the past year in the fight against domestic violence see No Visible Bruises: What We Don’t Know About Domestic Violence Can Kill Us, New York: Bloomsbury Publishing, 2019. Some sixty percent of domestic violence (DV) victims are strangled at some point during an abusive relationship (p. 65): Big red flag that the perpetrator is escalating in the direction of homicide/Femicide.
Empathy almost always has its uses when tuned to the specific circumstances. Yet empathy is unhelpful in dealing with sociopaths, psychopaths, and [most] bullies. They take whatever empathy you give them and use it the better to manipulate. Top down, cognitive empathy – yes – to understand whether they are a threat and are going to escalate; but therapeutic empathy – “i get you, bro” – is often counter productive. What is productive? Set limits. Set firm boundaries – and enforce them.
Turns out that only some 15% of the victims in one study had injuries visible enough to photograph for the police report (p. 66). Most strangulation injuries are internal – hence, the title. Good news/bad news: The Fatality Review Board is an idea that is getting attention with law enforcement and the local states attorney function. More progress and action is needed in this area.
(1) People stop saying, “I just don’t get empathy” and commit to the practice of empathy. Empathy is a practice and, like all practices, it can be improved by training. Remove the obstacles to empathy such as cynicism and bullying—and empathy comes forth. Remove the resistances to empathy and empathy naturally and spontaneously expands. Most people are naturally empathic.
The one-minute empathy training is trending: Eliminate the obstacles to empathy and a space of acceptance and toleration spontaneously emerges.
Most people do not sufficiently appreciate this: people are born with a deep and natural capacity for empathy, but they are also born needing to learn manners, respect for boundaries, and toilet training. Put the mess in the designated place or the community suffers from diseases. People also need to learn how to read and do arithmetic and communicate in writing. But there is a genuine sense in which learning to conform and follow all the rules does not expand our empathy or our community. It does not help the cause of expanded empathy that rule-making and the drumbeat of compliance are growing by leaps and bounds.
The work at hand? Remove the blocks to empathy such as dignity violations, devaluing language, gossip, shame, guilt, egocentrism, over-identification, lack of integrity, inauthenticity, hypocrisy, making excuses, finger pointing, jealousy, envy, put downs, being righteous, stress, burnout, compassion fatigue, cynicism, censorship, denial, manipulation, competing to be the biggest victim, insults, injuries to self-esteem, and narcissistic merger—and empathy spontaneously expands, develops, and blossoms. Now that is going to require some work!
Teaching empathy consists in overcoming the obstacles to empathy that people have acquired. When the barriers are overcome, then empathy spontaneously develops, grows, comes forth, and expands. There is no catch, no “gotcha.” That is the one-minute empathy training, pure-and-simple.
References and Notes
“The One-Minute Empathy Training”
May I introduce myself? Here is a short introduction to who i am and my commitment to empathy, including a one-minute empathy training. Total run time: about five minutes. Further data: See also
(c) Lou Agosta, PhD and the Chicago Empathy Project
Review: Empathy and Mental Health by Arthur J. Clark
Empathy and Mental Health: An Integral Model for Developing Therapeutic Skills in Counseling and Psychotherapy. London: Routledge 2022 Electronic Version
As a young man, Arthur J. Clark heard Carl Rogers speak and was inspired to devote his life’s work to applying empathy in education, counseling, and talk therapy. This book is the distillation of years of experience and learning, and we, the readers, are enriched and even enlightened in this original synthesis of existing ideas on empathy. It is fully buzz word compliant, diligently calls out the limitations and risks of empathy, and guides the readers in expanding their empathy to make a difference in overcoming suffering and mental illness. It takes a lot of empathy to produce a book on empathy, and empathy is evident in abundance in Clark’s work.
As noted, Clark’s academic background is in education, as was Carl Rogers’, but the reader soon discovers Clarks’ work with empathy to be generously informed by Freud, Ferenczi, and Adlerian psychoanalysis. Thus Clark quotes [Alfred] Adler (1927): “Empathy occurs in the moment one individual speaks with another. It is impossible to understand another individual if it is impossible at the same time to identify oneself with him” (Clark: 20). At this same time this reviewer was enlivened by the application of distinctions to be found in the Self Psychology of Heinz Kohut and the latter’s colleagues Michael Basch and Arnold Goldberg. This brilliant traversal of the practice and conceptual landscape of empathy inspired Clark’s life work, and is on display here.
The book is filled with short segments of transcripts of encounters between counselor/therapist and client. To the point that empathy is much broader than reflecting feeling and meanings, examples are provided of empathic encouragement, empathic being in the here and now (immediacy), empathic silence, empathic self-disclosure, empathic confrontation, empathic reframing, empathic cognitive restricting, empathic interpretation. Clark’s work with empathic reframing, cognitive restructuring, and interpretation are particularly useful (Clark: 105 – 106).
“Empathy” is not so much a substantive as a modifier – a manner of being that applies across a diversity of ways of relating to the other individual. (It is a further question, not addressed by Clark, as to the status of these vignettes. Are they disguised, permissioned, ideal types, some combination thereof? Just curious. In any case, they work well and remind me of M. F. Basch’s vignettes in the latter’s Doing Psychotherapy.)
Clark makes reference to the celebrated video (e.g., widely available on Youtube) of Carl Rogers, interviewing the real-world patient “Gloria” about her relationship with her nine-year-old daughter “Pammy.” Rogers’ empathic listening skillfully turns the focus from Gloria’s presenting dilemma of how much information about sex to share with her inquisitive nine-year-old daughter, Pammy, into a willingness on the part of Gloria’s to call out her own blind spots and conflicts over sex. Rogers’ empathic responsiveness shows the way for Gloria to recapture her own integrity around adult sexuality so that she can provide Pammy with the appropriate sex education the child needs, regardless of the details that may be relevant only to the adults. And Rogers does this in about twenty minutes, not months of therapy.
At this point, it is useful to give Rogers’ definition of empathy (p. 11): “To perceive the internal frame of reference of another with accuracy and with the emotional components and meanings which pertain thereto as if one were the person, but without ever losing the ‘as if’ condition.” Rogers was definite about excluding the perspectives of the practitioner in conceptualizing empathy in his person-centered approach to therapy. In this regard, he stated, “For the time being you lay aside the views and values you hold for yourself in order to enter another’s world without prejudice.”
Clark’s integration of the diversity of approaches to empathy in history, theory, and practice distinguishes subjective, object and interpersonal empathy: “Subjective empathy encompasses a practitioner’s internal capacities of identification, imagination, intuition, embodiment that resonate through treatment interactions with a client and empathically reflect the individual’s experiencing. Objective empathy pertains to the deliberate use of a therapist’s conceptual knowledge and data-informed reasoning in the service of empathically understanding a client in a relational climate. Interpersonal empathy relates to comprehending and conveying an awareness of a client’s phenomenological experiencing and pursuing constructive and purposeful change through the application of a range of interventions” (Clark: xiv).
Clark started out as a school counselor and he gives the example of the student who comes in and says “I hate school!” The reflection is proposed to be something like “You are feeling angry about school.” This demonstrates just how important the tone in which a statement is made can be. This could indeed be an angry statement, which takes “hate” is a literal way. However, it could also be an expression of contempt, disgust, cynicism, resignation, sadness, or even fear (say, since the student is being bullied). The empathy is precisely to acknowledge that the listener is far from certain that he does knows what is going on with the student and to ask for more data. “Sounds like you are struggling with school – can you say more about that?”
Not afraid of controversy or tough topics, Clark’s contribution is thick with quotations from the founding father of psychoanalysis – Adler and Freud and the literature Freud has been reading such as Theodor Lipps, to whom we owe the popularization in Freud’s time of the term “empathy [Einfühlung]. The subsequent generation of ego psychoanalysts is also well represented Ralph Greenson, T. Reik, Jacob Arlow (and Beres).
Clark credits and recruits Ralph Greenson’s distinction of the therapist’s inner working model of the patient and uses it to enrich Rogers’ contribution to empathic understanding. “As empathic understandings evolve through therapeutic exchanges and assessment interactions, a model of an individual emerges that becomes increasingly refined and expansive. In turn, by ways of empathically knowing a client, the framework facilitates sound treatment interventions through the engagement of interpersonal empathy” (Clark: 88). Note that Clark aligns with the view that the countertransference is distorting/pathological as opposed to the total response of the therapist. There are many tips and techniques guiding the therapist diligently to monitor and control the countertransference neurosis.
Since this is not a softball review, I note some issues for productive debate. For example, if Clark had allowed that countertransference included the therapist’s entire reaction to the client, including personal reactions which are not necessarily conflicted or neurotic (on the part of the therapist), then Clark would have been constrained to spend more ink on his own individual responses, empathic and otherwise. Such disclosure, which Clark otherwise separately validates as appropriate in context (and if not this context, then which?), would have enriched a text which otherwise reads like a textbook (and perhaps that was the editorial and marketing guidance).
Also useful is the therapist’s being sensitive to cultural differences and dynamics. In a brief transcript of an interaction between a privileged white school counselor and an African American 8th grader attending the college prep private school (Clark: 42), we are supposed to see objective cross-cultural empathy based on the counselor’s reading of some articles (not specified) on cultural differences.
By all means, read up on cultural differences. However, I just see a rigorous and critical empathy (my term, not Clark’s), plain and simple. The counselor “gets it.” The student is afraid of being seriously injured or even killed by the criminal element in his neighborhood as he waits for the school bus. Is this breakdown of policing in the inner city really in the cultural article? The counselor also “gets it” that the student’s feelings are hurt by being laughed at by his more privileged classmates because his mom is a house cleaner rather than an executive or doctor or lawyer. It is the counselor’s empathic response based on her empathic understanding of the student’s specific fear and hurt feelings that enables the student to deescalate from his problematic acting out. Even though, like most 8th graders, the student would be the last to admit he has been emotionally “touched,” he was. Thus, Clark’s empathy shines through in spite of his style-deadening need to accommodate behavioral protocols, evidence-based everything, and the plodding style of delivery consistent with training in schools of professional social work and psychology.
“Objective empathy” may seem like “jumbo shrimp,” an oxymoron. Nor is it clear how dream work, with which Clark productively engages, falls into the “objective” rubric. Yet it is a highly positive feature that Clark emphasizes and explores in detail the value of dream work.
Let one’s empathy be informed by the context: “Consider, for instance, what are the daily struggles like for a client who meets the diagnostic criteria for a bipolar disorder or attention deficit [. . . .] When giving consideration to such challenges through a framework of empathic understanding, a practitioner calls upon reputable data and a spectrum of work with individuals from diverse backgrounds in order to generate a more inclusive and accurate way of knowing a client” (Clark: 35).
And yet this precisely misses the individual who is superficially described according to labels, but has his own experience of bipolar or attention deficit. Empathy is precisely the anti-essentialist dimension, the dimension that is so pervasive in psychiatry and schools of professional psychology that replace struggling humanity with “You meet criteria for – [insert label].”
While Kohut is properly quoted by Clark as one of the innovators in empathy and Kohut’s concise definition glossing empathy as “vicarious introspection” is acknowledged, Kohut’s other definition of empathy as a method of data gathering about the other individual is overlooked. However, it aligns nicely with Clark’s description of “objective empathy.” Maybe my close reading missed something but why not just say “taking the other person’s perspective” is “objective empathy” as opposed to vicarious introspection (“subjective empathy”)?
The subtitle promises “An integrative model for developing therapeutic skills [. . . ]” Clark substantiates the need for work in critiquing all those training program that model the skill of repeating back to the client words similar to those the client expressed. “In a meta-analysis of direct empathy training, Lam et al. (2011) found that the majority of 29 studies did not clearly conceptualize or define empathy, some did not describe training delivery methods, and almost all of the initiatives failed to present evidence demonstrating individuals’ propensity to behave more empathically after training” (Clark: 140). Clark’s discussion of reframing, cognitive restructuring, and empathic interpretation are relevant and useful in overcoming what amount to a scandal in psychotherapy training.
What Clark is trying to say is this: You think you are being empathic. Think again. A rigorous and critical empathy (my phrase, not Clark’s) is skeptical about its own empathy. That does not mean being dismissive either of one’s own empathy or the struggle of the other person. It means being rigorous and critical. Empathy is made to shine in the refiner’s fire of self-criticism and a radical inquiry into one’s own blind spots.
Clark does not escape unscathed from the behavioral and observation protocol dead end. The reader will seek in vain for self-criticism or inquiry into Clark’s own blind spots – instead the reader is awash in the extensive behavioral, cognitive behavioral therapy (CBT) attempts, albeit empathically deployed, to capture therapeutic encounters in a behaviorally observable or reportable protocol. Nor I am saying there is anything wrong with that as such. Yet might not the behavioral and observation protocol swamp precisely be the blind spot where the self-deception lives against which Rogers frequently denounces? To gather the honey of self-knowledge and empathic understanding one must risk the stings of distortion and disguise.
Clark’s would be a different work entirely if he explored the college of hard knocks in which he forged the empathic integration. He is trying to make what is largely an artistic practice into a rule-governed scientific algorithm. It is worth a try and the reader must judge the extent to which Clark succeeds. Spending a lifetime preparing articles for peer-reviewed publications in education, psychology, etc., does not generally bring life and vitality to one’s practice, manner of engagement, or writing style. However, Clark’s richness of material, wealth of distinctions related to empathy, and organizing virtually every aspect of empathic research and published references goes a long way towards compensating for Clark’s work not necessarily being a “page turner.” Clark’s writing reminds the reader more of the Diagnostic and Statical Manual (DSM) – Ouch! – more than (for example) of D. W. Winnicot, Christopher Bollas, Arnold Goldberg, Freud, who was an expert stylist (granted much is lost in translation), or even Carl Rogers himself.
Thus, Clark’s integrated approach calls for “a diagnosis [as from the DSM] that represents the lived experience of the individual.” Agree. Clark gives an example where the therapist is interviewing Omar who has low energy, lethargy, lack of motivation, and hopelessness about the future. The diagnosis encapsulates and integrates a lot of Omar’s experience, and, though Clark does not say so, Omar may even be relieved to hear/learn that he (Omar) is not to blame for his disordered emotions (“major depression”); and Omar should stop making a bad situation worse by negative self-talk, verbally “beating himself up” in his own mind. The treatment consists in getting Omar to do precisely what the depressed person is least inclined to do – take action in spite of being unmotivated. If one is waiting to be motivated, absent a miracle, it is going to be a long wait. Maybe the empathic response is precisely saying this to the client, acknowledging how hard it is (and may continue to be for a while) to get into action on one’s own behalf.
This is all well and good. However, narrowly or expansively empathy is defined it is the anti-DSM (diagnostic and statistical manual). The DSM has many uses, especially in aligning terminology such that the community is talking about the same set of criteria when it uses the word “generalized anxiety disorder.” It also has uses in requesting insurance reimbursements. In short, there is nothing wrong with the DSM-5 (2013) or any version – but there is something missing – empathy. In the case of empathy, the recommendation is to relate to the struggling human being who presents himself in therapy, not to a diagnostic label.
Thus, Clark makes the case in his own terms: “From a humanistic perspective with central tenets focusing on respect for the individuality and uniqueness of a person, employing the DSM to categorize clients through a labeling procedure is thought to impede the growth of authentic relationships and empathic understandings of a deeper nature. In this regard, in a human encounter, perceiving a client through categorical frames of reference and symptomatic functioning hinders an attunement with the individual’s lived experiences and personal meanings. Moreover, applying a label to a client possibly influences a practitioner to shape preconceptions that are objectifying and forecloses a mutual and open-minded exploration of the contextual existence of the individual” (Clark: 27).
Though Clark does not say so, almost every major mental illness involves a breakdown of empathy. The patient experience isolation. “No one ‘gets’ me.” “No one understands what I am going through.” This is the case with most mood disorders, thought disorders, as well as those disorders typically described as “disorders of empathy” such as some versions of autism spectrum and anti-social personality disorders.
One matter of editing detail may be noted, a consistent misspelling of the name of celebrated primate researcher, philosopher, and empathy scholar Frans de Waal. There are no “Walls” in de Waal’s name – or in his empathy! We will charge this wordo to the editors who otherwise perform an admirable job.
Returning to a positive register, one of the most important takeaways from engaging with Clark’s work is that short therapy in which empathy is the driving force is powerful and effective. Clark does not specify the elapsed treatment in most cases, but I did not find one that was explicitly called out as being longer than fourteen weeks.
The emphasis is on the use of empathy in relatively brief psychotherapy – which is a powerful and positive approach that pushes back against the assertion that one needs cognitive behavioral therapy for relatively time-constrained encounters. Empathy produces quick results when skillfully applied. It is true that one of the great empathy innovators, Heinz Kohut, had some famous long and multi-year psychoanalyses; but these individuals were significantly more disturbed than Clark’s example of Anna, whose presenting behaviors were largely social awkwardness.
A strong point of Clark’s work is his debunking of the caricature of Rogers definition of empathy (and indeed of empathy itself) as merely reflecting (i.e., repeating) back to the speaker the words that the speaker has said to the listener. There is nothing wrong as such with reflecting what the other person has said, especially if the statement is relevant or well expressed. However, the mere words are pointers to the other person’s experience and are not reducible to the mere words. This is not a mere behavioral skill of reflecting back language, but a “being with” the other in the complexity and depth of the other’s experience as refined in the therapist’s own experience, and that is something one can best learn in years of one’s own dynamic therapy. Additional processing of the other person’s experience is encapsulated by and captured in the other person’s words, but not reducible to the words. The aspects of empathic responsiveness, embodiment, acknowledgement, recognition, encouragement, immediacy, possibility, clarification, and validation of the other’s experience form and inform the empathic response and the reply to the other.
A rumor of empathy is no rumor in the case of Clark’s work – empathy lives in his contribution to integrating the diverse and varied aspects of empathy.
Edwin Rutsch interviews the author Arthur J. Clark:
(c) Lou Agosta, PhD and the Chicago Empathy Project
A Critical Review of a Philosophy of Empathy (the book)
You don’t need a philosopher to tell you what empathy is; you need a philosopher to help you distinguish the hype and the over-intellectualization from a rigorous and critical empathy.
Every parent, teacher, health care worker, business person with customers, and professional with clients, knows what empathy is: Be open to the other person’s feelings,
Cover Art: A Critical Review of a Philosophy of Empathy
take a walk in their shoes, give them back their own experience in one’s own words such that they recognize it as theirs.
It is important to note that one may usefully take off your own shoes before trying on those of the other individual. This is perhaps implied in the folk definition of empathy, but overlooked in the over-intellectualization that occurs in academic treatments of the subject.
Okay – I’ve read enough – I want to order the book (compelling priced at $10 (US)): Order A Critical Review of a Philosophy of Empathy
So why is empathy in such short supply? Because we are mistaking the breakdowns of empathy – emotional contagion, conformity, projection, gossip, and getting lost in translation – for authentic empathy with one another in community. Drive out cynicism, shame, resignation, bullying, and empathy naturally shows up. There is enough empathy to go around. Get some here.
In this volume, Lou Agosta engages thirty three key articles from the great contributors to empathy studies such as William Ickes, Shaun Gallagher, and Dan Zahavi. Agosta distinguishes the hype from the substance, the wheat from the chafe, and the breakdowns of empathy from a rigorous and critical empathy itself as the foundation of community.
After debunking the prevailing scientism of empathy, this volume lays out a rigorous and critical empathy, leading the way forward with empathy studies that actually enable us to relate to one another.
rigorous and critical empathy itself as the foundation of community.
After debunking the prevailing scientism of empathy, this volume lays out a rigorous and critical empathy, leading the way forward with empathy studies that actually enable us to relate to one another.
Meanwhile, even more praise from the critics for A Critical Review of a Philosophy of Empathy by Lou Agosta
“Agosta’s book is at the right place and the right time. One of the most exciting things about emerging areas of academic study is when a dialogue can be enjoined among those with various insights. It is in this way that an understanding of the core subject matter (in this case empathy) can grow and be enriched. Lou Agosta’s latest book does just this. It begins with an artifact […] The Routledge Handbook of the Philosophy of Empathy (2017) and it engages with the various contributors individually and with some of the major themes in a multi-disciplinary way—such as social psychology and the phenomenology of empathy, and situates them into how empathy might be practiced. (Thus, it continues the practice-oriented methodology of Agosta’s Empathy Lessons that has been influential.)
“What makes A Review so successful is that we are presented with one mind (Agosta’s) in dialogue with many minds. This does two things: (a) it pulls together [the Handbook’s] vision; and (b) it extends the dialogue inviting other essays to be written to further enrich the dialogue. Both of these objectives creates space for the debate and discussion of empathy which has established itself as an important component of several disciplines, e.g., ethics, social/political philosophy, sociology, literary theory, and psychology. I predict that this influence will continue to grow. It is a great read for scholars and a crucial acquisition for university libraries.” Michael Boylan, professor of philosophy at Marymount University and author of Fictive Narrative Philosophy: How Literature can act as Philosophy,and the philosophical novel T-Rx: The History of a Radical Leader.
“In this, his fifth book, Lou Agosta cements his status as the preeminent expert on empathy. I, a psychologist and psychoanalyst, know of the view of empathy in my fields. Agosta here deftly acquainted me with the way empathy is seen by other disciplines, such as philosophy, cognitive science, neuroscience, anthropology, and aesthetics. With his lively mind and fluent, playful writing style, he enlightens and entertains the reader.” James W. Anderson, Clinical Professor of Psychiatry and Behavioral Sciences, Northwestern University, and President, Chicago Psychoanalytic Society (2017-2019)
“Lou Agosta calls it as he sees it. His distinct voice is both knowledgeable and radical in his advocacy of a conscious and deliberate embrace of empathy. He is passionate in putting forward that the understanding of empathy and its daily application is the essential element in improving the human condition in modern times.
“Lou Agosta’s most recent book in his series on empathy reviews the philosophical origins of empathy and current controversies. His tour de force reviews thirty three authors on empathy and makes a critical evaluation of both important contributions and limitations of the extensive literature regarding key concepts in the field of empathy studies. The book will appeal to those who believe empathy is critical in all aspects of interpersonal relatedness from psychotherapy to organizational culture.
“Topics covered include the core importance of empathy in human being. Empathy is reviewed from an historical perspective including philosophical, moral, aesthetic, cultural and clinical frames of exploration.
“Lou Agosta is a natural teacher and rare will be the reader who does not learn something significant from his new book.” Dennis Beedle, MD, former Chair, Department of Psychiatry, Saint Anthony Hospital, Chicago
Click here to order: Order A Critical Review of a Philosophy of Empathy
Short BIO: Lou Agosta, PhD, teaches and practices empathy at Ross University Medical School at Saint Anthony Hospital, Chicago, Il. He is the author of three peer-reviewed books in the series A Rumor of Empathyand the best selling, popular book, Empathy Lessons. His PhD is from the philosophy department of the University of Chicago and is entitled Empathy and Interpretation. He is an empathy consultant in private practice in Chicago, delivering empathy lessons, therapy, and life coaching, to individuals and organizations.
(c) Lou Agosta, PhD and the Chicago Empathy Project
Review: Empathy, Embodiment, and the Person by James Jardine
The occasion for James Jardine’s engaging and complex book is the publication of the critical edition of Husserl’s drafts for Ideas II, edited (separately) by Edith Stein and Ludwig Landgrabe as Husserliana IV/V [Hua]. Jardine notes:
“I draw upon a forthcoming volume of Husserliana which, for the first time, presents the original manuscripts written by Husserl for the project of Ideen II (Hua IV/V), a now-finished editorial task which was carefully pursued for several years by Dirk Fonfara at the Husserl-Archiv in Köln” [Jardine 2022: 4].
For this substantial scholarly contribution, we, the academic reading public, are most deeply grateful. We are also grateful for James Jardine’s penetrating and dynamic engagement with the cluster of issues around empathy, ego, embodiment and community raised in Husserl’s Ideas II. This is also the place to note that like many academic books, the pricing is such that individuals will want to request that their college, university, or community library order the book rather than buy it retail.
Empathy is a rigorous and critical practice. The commitment is always to be charitable in reviewing another’s work, and this is especially so when the topic is empathy. An empathic review of a work on empathy requires – sustained and expanded empathy. Any yet is not a softball review and Jardine’s work presents challenges from logical, phenomenological and rational reconstruction perspectives. It is best to start by letting Jardine speak for himself and at some length:
“I motivate and explore in detail the claim that animate empathy involves the broadly perceptual givenness of another embodied subject as experientially engaged in a common perceptual world. Interpersonal empathy, which I regard as founded upon animate empathy, refers by contrast to the fully concrete variety of empathy at play when we advert to another human person within a concrete lifeworldly encounter” [Jardine: 5].
“ […] [O]nce we recognise that the constitution of a common perceptual world is already enabled by animate empathy—without an analysis of the latter being exhausted by our pointing out this function—this allows us to render thematic the specific forms of foreign subjectivity and interpersonal reality that are opened up by interpersonal empathy, which involves but goes far beyond animate empathy” [Jardine: 88].
The key distinction is clear: “animate empathy” is distinct from “interpersonal empathy.” This distinction is widely employed in empathy scholarship, even if not in these exact terms, with many varying nuances and shades of meaning. This distinction roughly corresponds to the distinctions between affective and cognitive empathy, between empathic receptivity and empathic understanding, and, most generically, between “top down” and “bottom up” empathy. Arguably, the distinction even corresponds to that between the neurological interpretation of empathy using mirror neurons (or a mirroring system just in case mirror neurons do not exist) and the folk definition of empathy as “taking a walk in the other person’s shoes (with the other’s personality)”.
I consider it an unconditionally positive feature of Jardine’s work that he does NOT mention mirror neurons, which are thoroughly covered elsewhere in the literature (e.g., V. Gallese, 2006, “Mirror Neurons and Intentional Attunement,” JAPA).
From a phenomenological point of view, Jardine succeeds in showing that Husserl is a philosopher of empathy – animate empathy. Even if Maurice Merleau-Ponty does carry the work of phenomenology further into neurology and psychology, having inherited Jean Piaget’s chair, Husserl is already the phenomenologist of the lived experience of the body. The human (and mammalian!) body that one encounters after every phenomenological bracketing and epoché is a source of animate expressions of life. A pathological act of over-intellectualization is required not to see the body as expressing life in the form of sensations, feelings, emotions, affects, and thoughts. There are dozens and dozens of pages and lengthy quotations devoted to this idea. Here are a couple of quotes by Husserl that make the point:
“We ‘see’ the other and not merely the living body of the other; the other itself is present for us, not only in body, but in mind: ‘in person’” (Hua IV/V 513/Hua IV 375, transl. modified [1917]).
“The unity of the human being permits parts to be distinguished, and these parts are animated or ensouled (beseelt) unities (Hua IV/V 582 [1916/1917])” [Jardine 2022: 78].
Animate empathy LIVES in Husserl’s Ideas II. In addition, the shared space of living physical bodies creates a clearing for the intersubjective perception of natural (physical) objects in the common world of things and events. In that sense, empathy is at the foundation of the shared intersubjective world of thing-objects (as Heidegger would say “present to hand”).
However, the big question – for Husserl, Jardine, and all of us who follow – is does Husserl’s version of empathy found the intersubjective world of conscious human beings with intentional perceptions, emotions, actions, and personal engagements?
After nearly three hundred pages of engaging, useful, and lengthy quotations from Landgreb’s and Stein’s drafts of Ideas II, closely related texts of Husserl, and Jardine’s penetrating and incisive commentary, this reviewer was still not sure. In addition to my own shorting-comings, there are significant other reasons and considerations.
Jardine’s work is an innovative train-wreck, rather like Leonardo’s fresco the “Last Supper” – even at the start, da Vinci’s masterpiece was a magnificent wreck as the underlying plaster of the fresco did not “set up” properly. In this case, the underlying plaster is Husserl’s “work in progress” of Ideas II. (I acknowledge “work in progress” is my description, not Jardine’s.)
As is well known, Husserl himself withheld the manuscript of Ideas II from publication. He was not satisfied with the results, having been accused of succumbing to the problematic philosophical dead-end of solipsism, the inability to escape from the isolated self, knowing only itself. Will empathy solve the problem?
It is a further issue (not mentioned by Jardine) that everything without exception that Husserl actually published in his life about empathy after he published Ideas I (1913), makes “empathy [Einfühlung]” nonfoundational in relation to the givenness of the other individual, displacing it “upstairs.” For example, Husserl writes in the Cartesian Meditations:
“The theory of experiencing someone else, the theory of so-called ‘empathy [Einfühlung],’ belongs in the first story above our ‘transcendental aesthetics’” [Husserl 1929/31: 146 (173); see also Agosta, 2010: 121].
Now strictly speaking, Jardine could reply that quoting Husserl’s Cartesian Meditations is out of scope for an engagement with Ideas II, and that is accurate enough as it stands; but what is not out of scope is the challenge of solipsism with which Husserl was wrestling philosophically throughout his career. As noted, at the level of the Cartesian Meditations (which Jardine does occasionally quote when it suits his purpose (but not the above-cited quote!)), empathy belongs to the first story upstairs above his “transcendental aesthetics,” as Husserl writes, quoting a Kantian distinction.
Thus, we engage with Jardine’s implicit reconstruction of Husserl’s repeated attempts to navigate the labyrinth of phenomenological experience, joining and separating the subject/self and other individual.
Jardine follows Husserl from the solipsistic frying pan into the fire by quoting Husserl accurately as saying the self and other are separated by an abyss:
“Husserl calls out a “series of appearances (…) are exchanged, while each subject yet remains ineluctably distinct from every other by means of an abyss, and no one can acquire identically the same appearances as those of another. Each has his stream of consciousness displaying a regularity (Regelung) that encompasses precisely all streams of consciousness, or rather, all animal subjects (die eben über alle Bewusstseinsströme bzw. Animalischen Subjekte übergreift)” (Hua IV/V 254–255/Hua IV 309, transl. modified [1913])” [Jardine: 134 (emphasis added)].
Husserl tries a reduction to absurdity to escape from the solipsistic world of this abyss between self and other, supposing the world really were mere semblances. One will eventually encounter a person who is a non-semblance. This other individual who transforms the mere semblance into actually appearance awakens one from the dream of solipsism If it could be shown or argued that this other individual is necessarily given/presented/encountered, then all one’s previous solipsistic experience would be like hallucinatory madness. With apologies to Hilary Putnam, this is Husserl’s “brain in a vat” moment [Jardine: 126]:
“…[A]ny intersubjective “apperceptive domain”, Husserl claims, it is conceivable that, in the solipsistic world, “I have the same manifolds of sensation and the same schematic manifolds,” and, in as much as functional relations hold between such manifolds, then it may be that “the ‘same’ real things, with the same features, appear to me and, if everything is in harmony, exhibit themselves as ‘actually being’” (Hua IV/V 295 [1915]; cf. Hua IV 80). And yet, if other human living bodies were to then “show up” and be “understood” as such, the feigned reality of our experienced ‘things’ would be called into question:
Now all of a sudden and for the first time human beings are there for me, with whom I can come to an understanding [. . . .] As I communicate to my companions my earlier lived-experiences an d they become aware of how much these conflict with their world, constituted intersubjectively and continuously exhibited by means of a harmonious exchange of experience, then I become for them an interesting pathological object, and they call my actuality, so beautifully manifest to me, the hallucination of someone who up to this point in time has been mentally ill (Hua IV/V 295–296/Hua IV 79–80, transl. modified [1915])” [Jardine: 126].
This is a remarkable passage from Husserl, and we are indebted to Jardine’s scholarship for calling it to our attention. The thing that is missing or must be rationally reconstructed in Husserl is the necessity of the givenness of the other; but then, of course, the hermeneutic circle closes and the problem of solipsism is undercut, does not arise, and the character of phenomenology shifts. As is often the case, the really interesting work gets done in a footnote:
“For Husserl, this insight, that a phenomenological treatment of the constitutive relation between subject and world would have to address the (co-)constitutive role played by intersubjectivity, raises issues which cannot be addressed by a single analysis, but which rather demand a rethinking of the entire project of phenomenology” [Jardine: 127 (footnote) (reviewer’s embolding)].
There is nothing wrong with Jardine’s argument, yet, as noted, since this is not a softball review, there is something missing. The distinction “reconstruction” or “rational reconstruction” may usefully be applied to Husserl’s description and/or analysis of empathy. Jardine attempts to cross the abyss by means of interpersonal empathy. To that purpose, Jardine marshals the resources of narrative and of Alex Honneth’s distinction of “elementary recognition.”
To his credit, Jardine holds open the possibility that Husserl’s use of “empathy” does provide the foundation, at the time of Ideas II (1915 – 1917 and intermittently in the 1920s as Stein and Landgrabe try to “fix” the manuscript). Yet Jardine pivots to Alex Honneth’s (1995) key distinction of recognition (“elementary recognition,” to be exact) to provide the missing piece that Husserl struggled to attain. I hasten to add that I think this works well enough, especially within the context of an implied rational reconstruction of empathy within Husserlian/Honnethian dynamics and Husserl’s verstickung in solipsism.
However, this move also shows that Husserl did not quite “get it” as regards empathy being the foundation of interpersonal relations or community. As noted, Husserl is quite explicit in his published remarks that empathy gets “kicked upstairs” and is not a part of the foundation but of the first story above immediate experience, which as those in Europe know well is really the second story in the USA.
As noted, Jardine makes the case for bringing in supplementary secondary, modern thinkers to complement the “work in progress” status of Ideas II as a “messy masterpiece” (Jardine’s description, p. 4). I hasten to add that I do not consider Edith Stein a secondary thinker as her own thinking is primarily and complexly intertwined with that of Husserl. Likewise, Dan Zahavi is an important thinking in Jardine’s subtext and background, whose (Zahavi’s) contributions on empathy and Husserlian intersubjectivity (Husserliana XIV – XV) align with my own (2010) and are not an explicit part of the surface structure of the Jardine’s text.
Relying on the good work that Jardine initiatives, the reconstruction of Husserl’s relationship to empathy can be done in three phases. Husserl first attempts straightaway to connect the subject/self and the other individual person using empathy in Ideas I (1913). This results in the accusation of solipsism. The accusation “has legs,” because arguably Husserl fails to clarify that the other is an essential part of the intentional structure of empathy, even if the noematic object is inadequate or unsatisfied in a given context. Husserl then tries different methods of crossing the “abyss,” including Ideas II and the animate empathic expressions of the lived body. Husserl himself is not happy with the result as it does not quite get to what Jardine properly calls “interpersonal empathy.” At the risk of over-simplification, “interpersonal empathy” what happens we when “get understood” by another person in the context of human emotions and motivations.
The engagement with the critical edition of the second and third volumes of Ideas, provides extensive evidence that for Husserl, the world of experience is dense with empathy. But at the level of Ideas II (and HuaIV/V), there is an ambivalence in Husserl whether he wants to make empathy a part of the superstructure or infrastructure of the shared, common intersubjective world (especially non-animate things in that world). This can be tricky because, as Jardine makes clear, animate empathy is enough to give us intersubjective access to a world of physical objects and things. However, that is still not intersubjectivity in the full sense of relating to other selves who are spontaneous separate centers of conscious emotional and intentional acts.
I have suggested, separately (Agosta 2010, 2014) that Husserl steps back in his published works from embracing the intentional structure of empathy (in all its aspects) as full out foundation of intersubjectivity. However, in the Nachlass, especially Hua XIV and XV, empathy is migrating – evolving – moving – from the periphery to the foundation of intersubjectivity in the full sense of a community of intentional subjects.
Meanwhile, Husserl attempts to constitute intersubjectivity along with empathy (the latter as not foundational) by reduction to a “sphere of ownness” in the Cartesian Meditations (1928/32). The debate continues and Husserl later elaborates the distinction lifeworld (Lebenswelt), arguably under the influence of Heidegger, Scheler, and others, which lifeworld, however, is applied to nature not social human community. Husserl’s Nachlass, especially volumes Hua XIV and Hua XV demonstrate in detail that Husserl was moving in a hermeneutic circle and empathy was evolving from the periphery to the foundation of intersubjectivity (Zahavi 2006; Agosta 2010, 2014).
In lengthy quotations for the Cartesian Meditations and Phenomenological Psychology, Jardine validates that Husserl engages with personal character in the sense of personality. Jardine is on thin ice here, for though Husserl calls out “autobiography” and “biography” – and what are these except “self writing” and “life writing,” yet that is a lot to justify that Husserl goes more than two words in the direction of narrative.
Of course, one can build a case for a rational reconstruction of Husserl’s subtext as a hermeneutic phenomenology of narrative or the other as oneself and vice versa. And it results in the work of – Paul Ricoeur! That Husserl is not Paul Ricoeur – or Levinas or Heidegger or Merleau-Ponty or Sartre or Hannah Arendt, or, for that matter, Donald Davidson – takes nothing away from the innovations contributed by Husserl. It is rather a function of Jardine’s noodling with the interesting connections between all these. Nothing wrong with that as such – yet there is something missing – Husserl!
Therefore, the guidance to the Jardine is to let Husserl be Husserl. The author really seems to be unable to do that. There is nothing wrong with what Jardine is doing – from sentence to sentence, the argument proceeds well enough. But the reader finds himself in a discussion of “narrative” in the same sentence as Husserl and Ideas II. I hasten to add that I appreciate narrative as a research agenda, and have seven courses by Paul Ricoeur on my college and graduate school transcripts. And yet, once again, there is something missing – one can read Husserl against himself and maybe Jardine thinks that is what he is doing – but it is rather like what The Salon said about the paintings of Cezanne – he paints with a pistol – paint is splattered all over the place – the approach is innovative – but we were expecting impressionism and get – Jackson Pollack! We were expecting phenomenology and got – Donald Davidson or P.F. Strawson or Honneth – all penetrating thinkers, everyone, without exception.
In reading Jardine, I imagined that the transition from animate to interpersonal empathy could be facilitated – without leaving the context of Husserl’s thinking – by the many passages in which Husserl describes the subject’s body as being the zero point and the other’s as being another zero point.
Allowing for an intentional act of reversing position with the other, does this not provide an ascent routine to the folk definition of [interpersonal] empathy of “taking a walk in the other’s person’s shoes” [or, what is the same thing, the other person’s zero point]? Unless I have overlooked something, I do not find this argument in Jardine, though it might have been made the basis of a rational reconstruction of interpersonal empathy sui generis in Husserl without appeal to other thinkers. Thus, Jardine describes the “here/there” dynamic in Husserl:
“Accordingly, we can say that for a subject to empathetically grasp another’s living body she must comprehend it as a foreign bodily “here” related to a foreign sphere of sense-things (to which foreign “theres” correspond), where these are recognised as transcending – but also, at least in the case of “normality,” as harmonious with – my own bodily “here” and the sense-things surrounding it [. . . . ] Husserl suggests that, when the materiality of the other’s body ‘over there’ coincides, in its “general type,” with my own lived body ‘here’ in its familiar self-presence, “then it is “seen” as a lived body, and the potential appearances, which I would have if I were transposed to the ‘there,’ are attributed to as currently actual; that is, an ego is acknowledged in empathy (einverstanden wird) as the subject of the living body, along with those appearances and the rest of the things that pertain to the ego, its lived experiences, acts, etc.” That is, alongside the perceptible similarity of my lived body and the other’s [. . . ], this empathetic apprehension of a foreign sphere of sense-things also rests upon a further structural feature of perceived space; namely, that each ‘there’ is necessarily recognised as a possible ‘here,’ a possibility whose actualisation would rest solely upon my freely executing the relevant course of movement’” [Jardine: 131].
Jardine performs engaging inferential and speculative gyrations to save Husserl from so much as a hint of the accusation of inconsistency instead of emphasizing that Husserl’s use and appreciation of empathy develops, evolves, is elaborated. Husserl gets more intellectual distance from and closeness to empathy as he learns of Max Scheler’s work on the forms of sympathy and Heidegger’s work on Mitsein (which, I hasten to add, are in Jardine’s extensive and excellent footnotes and references).
Another approach to crossing the abyss between self and other is a transcendental argument. This goes beyond anything Jardine writes, but if offered in the Husserlian spirit and if it helps to put his project in the broader context, then it warrants consideration.
The argument informally: The distinction between self and other is not a breakdown of empathy; the distinction is the transcendental requirement, the presupposition, for empathy. If I lose the distinction between self and other, then I get emotional contagion, conformity, projection (Lipps), or communications that get lost in translation. Only if the distinction between self and other stand firm, is it possible, invoking aspects of acts of empathic intentionality, to communicate feelings (sensation, emotion) across the boundary between self and other; relate to the other individual as the possibility of reciprocal humanity; take a walk in the other’s shoes with aspects of their personality; and respond empathically to the other with performative linguistic acts of recognition. We do not merely express recognition; we perform it, thereby, instituting mutual dignity.
Husserl’s blind spot in this area and – do I dare say it? – perhaps Jardine’s as well is a function of remaining at the level of a single subject phenomenology, at least until the elaboration of the distinction, life-world (Lebenswelt). Until we explicitly get to the lifeworld, what would a multisubject phenomenology look like? The short answer is Heidegger’s Mitsein, Levinas on the fact and face of The Other, Ricoeur on oneself as other, or Sartre on the gaze of the other bestowing individuality and identity on the one.
Along these lines, Jardine usefully identifies the text where Husserl credits the other with constituting the social self of the self. The other gives me my humanity and without the other’s constitutive activity, one does not get to be a human being. Here Husserl comes closest to acknowledging that the one individual gets her/his humanity from the other individual. This is Jardine directly quoting Husserl:
“I arrive at the construal of myself as a human being (in the sense of mind) by way of a comprehension of others, i.e., insofar as I comprehend them as centres not only for the rest of their surrounding world but also for my lived body, which is for them an object of their surrounding world. It is precisely thereby that I comprehend them as construing me similar to the way I construe them, thus as construing me as social human being, as comprehensive unity of living body and mind. Therein is rooted an identification between the ego that I encounter in direct inspection – as ego which has its lived body over and against it – and the ego of the other’s presentation of me, the ego that the other can understand and posit, at one with my living body as, for the other, present “externally,” in acts which I for my part attribute to the other. The comprehensive presentation others have, or can have, of me is of service to me as regards the construal of myself as social “human being,” hence the construal of myself totally different from the way I apprehend myself in direct inspection. By means of this construal, with its complicated structure, I fit myself into the human family (Menschheitsverband), or, rather, I create the constitutive possibility for the sense of this “family.” I can now say “we,” and then for the first time do I become “I” and the other precisely another” (Hua IV/V 218–219 [1913]; cf. Hua IV 325, 242)” [Jardine: 227].
This is one of the most innovative things Husserl ever wrote – too bad it is such a bad fit with a one-person phenomenology. As Husserl famously puts the point in the Cartesian Meditations, the verifiable accessibility of others, and with this their existential character for me, consists exactly in their original inaccessibility (Hua I: 144) [Jardine: 81]. Two steps forward; one backwards?
However, even within a one-person phenomenology, one can rationally reconstruct an extension of Husserl’s thinking, going beyond Husserl and Jardine here, that dialectically mediates original and nonoriginal experience as allowing a third term – vicarious experience.
Phenomenologically what is missing is the distinction “vicarious feeling” or “vicarious experience.” Max Scheler elaborated such a distinction as Nachfühlen or Nachleben, and Jardine notes Scheler in the footnotes without, however, making the phenomenological connection to an intermediate form of experience between originally owned and nonoriginal. A vicarious experience is my original experience of another person’s original experience. So is it original? My experience is by definition original, but the other’s original experience is nonoriginal to and for me. So, the distinction between original and nonoriginal breaks down and is mediated by vicarious experience, an experience of the other that is mine own without my being the other. Hidden in plain view? (For further details on Scheler see Agosta 2014a.)
Another path to intersubjectivity that Husserl calls out but that both Husserl and Jardine leave undeveloped is that of joint intentionality. Key term: joint intentionality. There is very little new under the sun, but Michael Tomasello (2008) and R. Peter Hobson (2005) have separately and innovatively elaborated this distinction, “joint intentionality.”
Consider an example. The placement of the parenthesis is key: “I see the cathedral.” “You see the cathedral.” “I see you (you see(ing) the cathedral).” Once my intentionality includes yours, we have a non-solipsitic relationship. Solipsism is undercut and cannot become a serious issue. My intentionality in relating to another can be inadequate or unsatisfied, but an inadequate or unsatisfied relatedness to an other is still relatedness.
We can misunderstand one another, which means we can clarify the misunderstanding and reach an understanding. This would give us what Jardine calls interpersonal empathy. Thus, Jardine identifies “joint intentionality” in Husserl (without, however, identifying it as such):
“As Husserl notes, if I am looking at a cathedral and I notice another standing by me, ‘his gaze directed at this cathedral, then I understand this without any further ado. His seeing, which I experience through empathy, is equally an immediate having-over-against: the object is immediately given’ (Hua IV/V 510–511/Hua IV 373, transl. modified [1917]). While we normally only take human others to see a cathedral as a cathedral—in that this sense is one generated and sustained by human experience and social praxis—Husserl’s claim that we would empathetically take the other to immediately see the ‘colossal black thing’ (which is a cathedral for us) surely holds with regard to some non-human animate others too” [Jardine: 140].
Once again, a powerful approach, if not a complete answer, is “hidden in plain view.” In a sense, it is a scandal that we still lack a thorough intentional analysis of empathy. So here it is: The other and the other’s intention are a fundamental part of the structure of empathy. Empathy aims at and includes the other. Without the other, empathy is not empathy. It is emotional contagion or conformity or projection or misunderstanding.
Another consideration. Is the distinction between animate and interpersonal empathy exhaustive? Is “sustained empathy” different than “interpersonal empathy”? This would be analogous to the difference between a snapshot – a single instance – and a video – a series of instances across time (for more on “sustained empathy” see Goldberg, 2015: 89 – 98). Like a video as opposed to a snapshot, sustained empathy opens up possibilities, emergent properties, and a depth of engagement, that is at a qualitatively different level than an isolated encounter. One has to listen to another person and respond to them empathically over a period of time and get to know them in order to appreciate not just that (for example) the person is angry and what triggered the anger, but the motivational, development, historical, emotional, and even the future context in depth. When interpersonal empathy is sustained across time and numerous encounters with the other person, then a network of empathic relatedness, empathic responsiveness, and authentic human relations based in empathy opens up.
Never underestimate Husserl. Never underestimate empathy. Never. Jardine quotes Husserl as describing sustained empathy (the term is not used). It remains unnamed, but, I submit, it is not reducible to animate and/or interpersonal empathy. This begins a new thread and perhaps a new book. It is best to let Husserl have the next to last word [Jardine: 266]:
“ …[W]e can now see why Husserl regards fully understanding another person as an infinite task, and maintains that reaching its ideal form would require me to relive the other’s personal live in extenso, and to comprehend the developmental contours of her personal character by situating them within an infinitely detailed narrative (Hua IV/V 458 [1916/1917]). A deep understanding of another person’s actions, emotions, and beliefs can always be informed by familiarising oneself with their personal character and the history of its coming-to-be, and on the other hand, such an understanding is exactly a way of acquiring and developing such a familiarity (Hua IV/V 579 [1916/17]; see also Hua IV/V 312 (HuaIV 104) [1915]). Consequently, our ability to envisage and understand the motivational context of another’s actions is best seen as embedded within ongoing personal relationships, in which our acquaintance with the other person’s character has gradually developed through repeated empathetic contact, as well as through communicative engagement and, more generally, through participating with the other in a common human world.”
Having urged “let Husserl be Husserl,” I have a final thought about what is missing from the entire discussion of empathy in Husserl, Jardine, and the philosophical handbooks of empathy, and this is so even if one includes “sustained empathy” as having been implicitly engaged (even though I would maintain that is not the case). When a person receives empathy, when a person “gets a good listening,” when a person is responded to empathically, when a person experiences authentic relatedness to another – regardless of the form – then the person often experiences an opening in what is possible in the person’s life, choice, and situation. The person is empowered by the empathy to inquire into what is available and accessible for him- or herself that goes beyond mere psychology into a fundamental inquiry that transforms possibilities of knowing and acting. Something in the person’s way of being and relating changes, shifts, transforms. The person shifts out of stuckness and into action that makes a profound and positive difference. How does that come about? Now that is something worthy of further inquiry.
References
Review: Empathy, Embodiment, and the Person: Husserlian Investigations of Social Experience and the Self by James Jardine. Chaum, Switzerland: Springer Nature. ISSN 0079-1350 ISSN 2215-0331 (electronic). ISBN 978-3-030-84462-2 ISBN 978-3-030-84463-9 (eBook). https://doi.org/10.1007/978-3-030-84463-9
Zahavi, D. (2005). Subjectivity and Selfhood: Investigating the First-Person Perspective. Cambridge, MA & London: The MIT Press.
Michael Tomasello. (2008). Origins of Human Communication. Cambridge, MA: MIT Press.
Arnold Goldberg. (2015). The Brain, the Mind and the Self. New York: 2015.
V. Gallese, 2006, “Mirror Neurons and Intentional Attunement,” Journal of the American Psychoanalytic Association.
R. Peter Hobson. (2005). What puts the jointness into joint attention. In Joint Attention: Communication and Other Minds, eds. Naomi Eilan et al Oxford, UK: Oxford (the Clarenon press): 185 – 204).
Edmund Husserl. (1929/31). Cartesian Meditations, tr. D. Cairns. The Hague: Martinus Nijhoff, 1970.
_________________. (1929/35). Husserliana XV. Zur Phänomenologie der Intersubjektivität. Texte aus dem Nachlass. Dritter Teil: 1929-1935. Ed. I. Kern. The Hague: Martinus Nijhoff, 1973
_________________ .(1921/28). Husserliana XIV. Zur Phänomenologie der Intersubjektivität. Texte aus dem Nachlass. Zweiter Teil: 1921-1928. Ed. I. Kern. The Hague: Martinus Nijhoff, 1973
_________________. (Forthcoming). Husserliana IV/V. Ideen zu einer reinen Phänomenologie und phänomenologischen Philosophie. Zweites Buch: Phänomenologische Untersuchungen zur
Konstitution und Wissenscahftstheorie. Ed. D. Fonfara. Cham: Springer.
Alex Honneth. (1995a). The Struggle for Recognition. The Moral Grammar of Social Conflicts, tr. J. Anderson. Cambridge: Polity Press.
Lou Agosta. (2010). Empathy in the Context of Philosophy. London: Macmillan (Palgrave).
_________. (2014a). Rewriting empathy in Max Scheler. In A Rumor of Empathy: Rewriting Empathy in the Context of Philosophy. New York: Palgrave Macmillan: 83 – 96. DOI:10.1057/978113746534.0009.
_________. (2014). Husserl’s rewriting of empathy in Husserl. In A Rumor of Empathy: Rewriting Empathy in the Context of Philosophy. New York: Palgrave Macmillan: 97 – 118. DOI:10.1057/978113746534.00010.
(c) Lou Agosta, PhD and the Chicago Empathy Project
Transference and Empathy: Where Transference Was Empathy Shall Be!
Listen as podcast on Spotify by Anchor: https://open.spotify.com/episode/6ZFSOgaTe0x1fQvFuKFTgJ
[Note: the audio is not a exact transcript and sometimes covers the same or related material using different words]
While empathy is seemingly in exceedingly short supply in the world, you do not need a philosopher to tell you what empathy is. Every mother, every teacher with students, every business person with customers, every doctor with patients, every attorney with clients, every politician with supporters, every person with next door neighbors, knows about empathy.
We shall start with the folk definition of empathy – take a walk in the other person’s shoes, and add one additional recommendation. However, first take off your own shoes before putting on the other’s – an action that is routinely overlooked – otherwise one gets projection, not an experience of otherness.
The title statement echoes Freud’s celebrated slogan “Where id was, ego shall be!” Neither of these statements is an “either or” proposition. The id is not going away. Freud did not propose to abolish the id with the ego. It is not even clear what that could possibly mean. The idea is to expand the influence, control, and power of the second term (ego, empathy) over the first one (id, transference). The ego expands its power, including power over primitive aggressive and sexual inclinations; likewise, with empathy. Empathy expands its power in creating an opening for effectiveness and success in fulfilling and satisfying human relationships.
Let us define our terms. Transference is the carrying across of meaning from one context, model, or paradigm to another one. It is difference than metaphor, which means a “carrying across or beyond,” but perhaps not by much. We humans have a tendency to make things mean other things. We humans are “meaning making machines,” in the sense that we are a source of acts of conscious intentionality that brings meaning to our encounters with nature and our fellow humans in community. There is indeed something mechanistic about the way we automatically go about making things mean things. We can’t seem to stop doing it, which results in innovations but also distortions and misunderstanding. We take behaviors, conversations, and circumstances and try to make sense out of them by bringing meaning to them, which sometimes applies, but sometimes doesn’t.
This definition of transference extends into the realm of so-called behavioral health and psychoanalysis (where it was initially and innovatively defined) into the contexts of diverse forms of psychotherapy, empathy consulting, professional coaching, or community building. At the risk of oversimplification, transference takes a cognitive, behavioral, or emotional response from one context, such as childhood or circumstances in the past that one had to survive, and uses it to respond to the therapist, coach, or trainer in a similar way. Typically this introduces distortion or extraneous issues into the relationship.
The relationship between transference and empathy is under theorized. This is the case in spite of all the great psychoanalysts from Freud onwards commenting on both subjects, albeit sometimes in widely separated contexts and conversations. There are many reasons for under development of theory, both scientific and political, but it is largely due to the nature of the phenomena themselves. Transference as a distinction is largely structural, even though its emergence and transformation unfold in time in the process of a therapeutic psychoanalysis. Empathy as a distinction is largely a process unfolding in the therapeutic relationship, even though it has structural invariants.
Empathy and transference are the opposite of one another. How so? In empathy one takes a walk in the shoes of the other person, the better to understand the other and relate authentically to the individual. There are many definitions of empathy, but they converge on the idea that empathy is an authentic form of relatedness. Get rid of the judgments, assessments, and evaluations, and be with the other person without applying labels, categories, and prejudices.
Now transference is the exact opposite of authentic relatedness. The narrow definition of transference says take a pattern or relating from one situation – such as childhood or an experience in another context – and apply it to the current relationship or situation. The result is a distortion of the relatedness. The result is an inauthentic way of relating. In order to bring forth an empathic relationship one has to interpret and resolve the transference distortions.
Let us take a step back. The implications of the relationship between empathy and transference, as noted, have not been much theorized. It is true that dozens of publication address empathy and dozens of publications address transference, and some even contain discussions of both empathy and transference (e.g., Racker 1968). But the specific interactions between being empathic in the transference and getting engaged in transference in being empathic in a clinical setting have not been much engaged.
The recommendation? Think of the relationship between empathy and transference (or perhaps you say “the transference” as if it were a single unified thing) as a dance. Sometimes the one leads and the other follows and vice versa. The implications of the dance between empathy and transference are profound, but complex and entangled.
Lest one imagine these two phenomena – empathy and transference – are inevitably at loggerheads, consider the following example of convergence:
The patient comes in and says he saw the film, Elephant Man (directed by David Lynch (1980)) and he was deeply moved. The narrative is of an individua, David Merrick, suffering from Proteus Syndrome (often confused with Neurofibromatosis), which results in disfiguring folds of tissue on the head and other pulmonary and renal abnormalities. “Deeply moved,” by what aspect in particular, I asked? After being a freak, physically disfigured, lacking humanity, David Merrick meets the doctor who acknowledges his humanity. The recognition of humanity – “I am a human being – I am a man” is the most dramatic utterance – and the empathic moment. The client reports being moved to tears and having had a satisfying cry. Without further discussion, the client then spontaneously speculates, wondering if there was a parallel with our relationship, my having recognized something in him that others had not seen. Without going into confidential details, I had seen around or though the significant blind spot that kept him insensitive to an aspect of father’s behavior which was running his life and in a destructive way, yet not acknowledged. This enabled the client to shift his relationship to his life partner (as well as his father) and move on. The parallelism – transference – the recognition of humanity – empathy.
To try to prevent misunderstanding, one must distinguish between transference in a narrow sense and transference in an enlarged sense. At risk of oversimplification, when transference was first discovered by Freud, it seemed like an obstacle to treatment, since the patient related to Freud as an authority figure such as The Father (in the case of a male patient) or as a seductive father figure (in the case of a female patient) whereas Freud regarded himself as a kind, even empathic, listener to the patient’s neurotic suffering.
Eventually Freud realized that the patient was relating to him (Freud) as to an important figure from the patient’s past. Regardless of how Freud tried to treat the patient, the patient treated him- or herself with transference – but responding with a transference of meaning from one area of the patient’s life to the relationship with Freud. Just as significantly, Freud discovered that the patient was doing this in other areas of his life as well – towards his lady friend, towards his superiors at work, in a hundred and one ways in his life – with problematic results that caused the individual to seek treatment for his suffering and conflicts.
For example, when the patient was a woman, the transference was not hostile but erotic. This can be motivated. If the reader saw Vigo Morgenstern play the middle-aged Freud in the film A Dangerous Method, then you know what I mean. This guy was hot! Though unlike Carl Jung, Freud was clear about professional boundaries: “[…] [T]he patient has transferred on to the doctor intense feelings of affection which are justified neither by the doctor’s behavior nor by the situation that has developed during the treatment” [1917, Introductory Lectures on Psycho-Analysis: 440 – 441]. It is in interpreting this transference – based on behavior different than that of the original seductive parental objects and suitable verbal feedback – that the cure of the neurosis is affected: “At the end of the analytic treatment the transference must itself be cleared away: and if success is then obtained or continues, it rests, not on suggestion, but on the achievement by its means of an overcoming of internal resistances, on the internal change that has been brought about in the patient” [1917, Introductory Lectures: 453]
Since this post is part of a larger project, I take the liberty of including several definitions of “transference” by leading figures who defined it. Those readers who wish less detail may skip ahead.
Thomas Szasz (1963: 432 – 443), who was otherwise a notorious psychoanalytic “bad boy,” denouncing the “myth of mental illness,” was an classic Freudian when it came to defining transference: “Freud conceived of transference love as an illusion because the situation in treatment cannot account for the origin of such feelings” [. . . .] [I]t [transference] is considered an expression of interest ‘basically’ directed towards childhood objects, deflected to the analyst or to the figures in the patient’s current life.”
Peter Giovacchini (1965: 287) writes that: “[. . . .] [T]ransference reaction refers to a person’s reactions to an object as they are determined by infantile unconscious factors. Viewing the object in terms of archaic imagos in a primary process orientation lead to irrational attitudes and distortions.”
Carl M. Grossman (1965: 249 – 250) defines transference in a broad sense that seems to go beyond the psychoanalytic context in a narrow sense: “[. . .] [Transference is] a universal human psychological characteristic which causes the internalized representation of certain objects – such as parents or parental surrogates from one’s infantile past – to be projected onto a succession of later, ostensibly unrelated persons. The transferring person then reacts to new objects with the anachronistically habitual reaction in adult life that he had had towards the originally cathected object in infancy.”
Ralph Greenson (1967: 151 – 152) asserts: “[. . . ] [Transference is] a special kind of relationship toward a person: it is a distinctive type of object relationship. The main characteristic is the experience of feelings to a person which do not befit that person and which actually apply to another. Essentially, a person in the present is reacted with as though he were a person in the past. Transference is a repetition, a new edition of an old object relationship” (pp. 151 – 152).” {TI: 339]
Leo Stone (1961: 66 – 67) writes “[…] [Transference is limited] to that aspect or fraction of a relationship which is motivated by persistent unmodified wishes (or other attitudes) toward an actual important personage of the past, which tend to invest a current individual in a sort of misidentification [. . . ] with the unconscious image of the past personage. It is essentially in appropriate to the current situation subjectively misunderstood as to genetic origin until analyzed, and tenaciously resistive to this analysis (pp. 66 – 67).” Stone further notes: “that a nuance of the analyst’s attitude can determine the difference between a lonely vacuum and a controlled but warm human situation, which does indeed offer these gratifications, along with its undoubted rigors” (1961: 21 – 22).”
In short, transference is what happens when human do what they cannot stop doing – trying to make sense of situations by assimilating them to patterns from key patterns and expectations based on experience. What may have been helpful in one context to enable the person to survive or even flourish is less helpful and even harmful in other situations in that distortions and misunderstandings are introduced.
There is a broader sense of “transference” that developed, in which transference becomes the entire relationship which the patient has towards the therapist. And wherever there is transference can countertransference be far away? Under this idiosyncratic and enlarged meaning, “countertransference” becomes the therapist’s way of relating to the patient. For example, according to Paula Heiman, under this idiosyncratic interpretation of the relationship, “counter- transference” covers all the feelings the analyst experiences toward the patient (see Paula Heiman, 1950. On counter-transference. International Journal of Psycho-Analysis 31: 81 – 84).
Of course, “counter transference” can mean an unprofessional or pathological response on the part of the therapist, as when s/he behaves in a moralizing, aggressive, or seductive manner; but it can also include appropriate and positive responses such as empathic ones. In the extreme, countertransference comes to mean empathy itself. Heimann’s thesis is “that the analyst’s emotional response to his patient within the analytic situation represents one of the most important tools for his work. The analyst’s countertransference is an instrument of research into the patient’s unconscious” (1950: 81). The transference is not empathy, but the countertransference is essential input to the empathic process, even if not quite reducible to empathy itself.
While Freud innovated decisively in decoding the meaning of dreams in The Interpretation of Dreams (1900) and the exploration of infantile sexuality, from a clinical perspective, the elaboration of transference defined the clinical encounter between patient and therapist in the context of psychoanalysis. Transference becomes co-extensive with the encounter between patient and therapist. If you can’t form a transference, since the therapy consists in interpreting and raising the transference, the therapy is not going to work.
We now turn from transference to empathy.
Freud explicitly states that unless the physician begins empathy in engaging in psychoanalysis, that physician is headed for trouble. The issue is that nearly no one knows that Freud said that because the Strachey’s mistranslate “empathy [Einfühlung]” as “sympathetic understanding.” I must insist on the point. We are on firm group as far as Freud’s guidance is concerned. “Empathy” and “sympathetic understanding” are not the same, and what is more, in a kind of Nachträglichkeit – or retrospective consideration – we lose the opportunity to connect to Freud’s guidance (see Agosta 2014). Thus, we have the kind of empathy wars that Heinz Kohut had to fight to demonstrate that empathy had a mutative effect on the structure of the self (presumably and especially including the ego).
When Freud demonstrated by his empathic way of relating to the patient (including by his verbal interpretations) that he was not the authoritarian or seductive parental figure of the patient’s past or trauma, the patient would often resist, deny, or offer other defensive gestures against Freud’s interventions and interpretations. But eventually the evidence would add up. Freud was not the unkind parent or the seductive uncle – the mischief was coming from the patient’s unconscious (and his circumstances), not from Freud. With this realization, the patient was reliably able to shift out of stuckness and enjoy a new beginning in his work and romantic relatedness thanks to Freud’s revolutionary new method of treatment.
Although there are numerous definitions of empathy, most include a narrow and an enlarged use of the term. In the narrow sense, empathy is a psychological mechanism, which, in folk psychology terms, as noted, consists in taking a walk in the other person’s shoes. It is rarely pointed out that one must take off one’s own shoes before putting on those of the other or one risks the distortion/defense of projection. As a psychological mechanism, Kohut defines empathy as vicarious introspection, though he does not merely define empathy in that way.
In an enlarged sense, empathy means being present with the other person without applying judgments, labels, or moralizing assessments. When I use the expression “empathic presence,” the word “presence” inevitably invokes Nacht (1962) and Nacht and Viderman (1960), who penetrating and insightful contribution should not be underestimated. However, as I use it the word “presence” should not be understood as a source or justification for any deviations in technique or the frame. If anything “presence” means “being with” one another in a Heideggerian sense or “being” in the sense of “going on being” as Winnicott employed the term. Even though not necessarily visible, if seated behind the couch, the analyst’s listening is a strong presence.
If one understands “transference” in a broad sense of all aspects of relatedness to the patient, then it tends to merge with an understanding of “empathy” as the foundation of relatedness.
Anything the analyst does to influence the transference is considered an issue – the question of the background to transference – passivity? Neutrality? Empathy? but empathy is the background to transference.
One of the most enlarged uses of the terms is to be found in Kohut. For Kohut empathy defines the entire field of therapeutic interrelations and one can even give a transcendental argument to that effect
Empathy is not just a useful way by which we have access to the inner life of man – the idea itself of an inner life of man, and thus of a psychology of complex mental states, is unthinkable without our ability to know via vicarious introspection – my explanation of empathy . . . what the inner life of man is, what we ourselves and what others think and feel. (1977: 306)
In this statement, empathy is the foundation of our relations to other individuals. This is a restatement and an expansion of Kohut’s celebrated statement in his 1959 article that empathy is the method of data gathering precisely about what other individuals feel and think. In turn, this method defines the scope and limits of psychoanalysis as a therapy and discipline. The field of empathy that of psychoanalytic therapy become co-extensive.
As noted, one individual does not directly access the mental states of the other person, but rather had a vicarious experience of the other person’s experience. In empathy one is receptive to the micro-expressions of the other person’s experience – one has an “after image” and a “vicarious” experience of what the other is experience.
The innovations continue. Kohut innovates around transference in 1971 – the establishment of what was first called idealizing transference and transference of the grandiose self and ultimately becomes selfobject transference is a distinct phase in the history of transference and tends to live like a split off bastion – for example, is there any evidence of a selfobject transference in the Wolfman, who had aspects of the depletion and grandiosity of narcissistic personality disorder?
The selfobject represents the function that other people have for oneself. Kohut: “[. . .] [T]he general meaning of the term selfobject [is] as that dimension of our experience of another person that related to this person’s function in shoring up [supporting the homeostatis / equilibriating] our self [. . .]” (1984: 49)
In a standard relationship people interact in such a way that they mutually regulate one another’s thoughts, feelings, and actions. This is called “friendship.” It is also the give-and-take at the foundation of many forms of interpersonal cooperation, communication, and collaboration. When one’s spouse comes home from a hard day at the office or clinic or the backroom on Zoom and you give them a good listening as they vent the frustrations, double binds and bullying perpetrated by the boss or client, then you are functioning as a selfobject. Presumably such an interaction or function did not begin with Kohut’s coining the term “selfobject,” though it was more clearly delimited out of the undifferentiated background.
One significant difference that, unfortunately, has resulted in controversy and lack of clarity, is how Kohut’s selfobject (narcissistic) transference is sustaining to the patient during the long process of interpreting, working through, and dissolving the transference and the inevitable transference distortions. Kohut took considerable pains to emphasize (and empathize!) that confrontational and moralizing methods would unleash reactive narcissistic rage on the part of the patient and that the empathic approach was critical path.
This lines up with and is complementary to one of Freud’s early discoveries was a later version of this phenomenon – that what seemed to be a source of resistance was actually the way forward. However, the way forward means the possibility of relatedness between internal objects (everything from the superego to hostile introjects to good breasts) and the therapist. Key term: relatedness. Thus, when there are disruptions in the relatedness between the patient and therapist that is conceptualized as a breakdown in the transference – the loss of connectedness, even if the connectedness includes distortions, misunderstandings, and conflicts. But that is usually the way it is thought of or described in the context of classical analysis where the breakdown of the transference often results in what seem like moralistic or objective medical judgments that the patient is not analyzable.
Instead, the relationship between transference and empathy comes into its own where, in the face of a breakdown in transference, empathy is used to restore the transference relationship.
For example, speaking of a patient with significant narcissistic disequilibrium, Kohut writes:
- When the narcissistic transference has become disrupted, he has the impression that he is not fully real, or at least that his emotions are dulled; he is doing his work without zest, that he seeks routines to carry him along since he appears to be lacking in initiative … ((1971): 16)
The restoration of the relatedness and the transference is brought forward when the therapist, using empathic understanding, shows the analysand that the therapist “gets” how the analysand is struggling with a setback or challenge in his life that he left him emotionally disequilibriated, anxious, lethargic, depleted. When this occurs repeatedly in the course of treatment, psychic structure is built and reinforced in the areas of emotional and behavioral regulation. A cure comes into view.
Kohut (1984: 66) writes: “[. . .] [The] aim and the result of the cure – is the opening of a path of empathy between self and selfobject, specifically, the establishment of empathic in-tuneness between self and selfobject on mature adult levels. [….] …the gradual acquisition of empathic contact with mature selfobjects is the essence of the psychoanalytic cure [. . .]” Of course, one must hasten to add that “empathic in-tuneness” is unlikely, even impossible, unless the distortions and illusions of the transference have been engaged interpretively (and in an empathic way) in course of making contact with mature selfobjects in empathic relatedness
A number of issues occur here that clearly require further research and clarification of terminology. Why would selfobject transference be considered transference at all? Here “transference” again gets used in the broadest sense of “empathic relatedness.” It represents healthy relatedness, good listening, and interpersonal well-being. Interpretation of the transference is a key bridge between empathy and transference – when the interpretation is experienced as unempathic then the aggression released is not due to a lowering or elimination of defense against the death instinct but a reactive rage at getting one’s feelings hurt at being misunderstood by one’s therapist, being re-traumatized in the transference by unempathic caretakers or disappointed parental idealizations.
If such relatedness with its significant component of a “good listening” is spontaneously constellated in the psychoanalytic therapeutic encounter, then it may at first glance seem to be pure positive transference (the analyst as “good object”) or positive nontransference reality-based relatedness. Indeed, Winnicott’s transitional object is a special case of a selfobject but shows that the selfobject is a standard part of development in which the imaginary is integrated into the rich system of conventions and symbols known as everyday life. In that sense, the family pictures on one’s writing desk are reminders of why one works, making the absent present in what is literally a picture of health.
Where transference was empathy shall be!
References
Szasz, Thomas. (1963). The concept of transference. International Journal of Psychoanalysis 44: 432 – 443.
Stone, Leo. (1961). The Psychoanalytic Situation. New York: International Universities Press. [TI: 239]
Reich, Annie. (1966). Empathy and countertransference. In Annie Reich, Psychoanalytic Contributions. New York: IUP Press, 1973: 344 – 360.
Nacht, S. (1962). Empathy as a psychological mechanism and empathy as presence (of course it is both). Symposium The curative factors in psycho-analysis. II International Journal of Psychoanalysis 43: 206 – 211
Kohut, Heinz. (1984). How Does Analysis Cure? Eds. Paul Sepansky and Arnold Goldberg. Chicago: University of Chicago Press.
Kohut, Heinz. (1977). The Restoration of the Self. New York: International Universities Press.
Kohut, Heinz. (1971). The Analysis of the Self. New York: International Universities Press.
Grossman, Carl M. (1965). Transference, countertransference, and being in love. Psychoanalytic Quarterly 34: 249 – 256.
Greenson, Ralph R. (1967). The Technique and Practice of Psychoanalysis vol 1. New York: International Universities Press.
Giovacchini, Peter L. (1965). Transference, incorporation and synthesis. International Journal of Psychoanalysis 46: 287 – 296.
Agosta, Lou. (2014a). Rewriting empathy in Freud. A Rumor of Empathy: Rewriting Empathy in the Context of Philosophy. New York: Palgrave Macmillan: 66 – 82. DOI:10.1057/978113746534.0009.
(c) Lou Agosta, PhD and the Chicago Empathy Project
On Guns: Historical Empathy and the Strict Construction of the US Constitution
I am sick at heart. This is hard stuff. All those kids. Teachers, too, dying trying to defend the children. Everyone cute as button. What to do about it? My proposal is to expand historical empathy. Really. Historical empathy is missing, and if we get some, expand it, something significant will shift.
Putting ourselves in the situation of people who lived years ago in a different historical place and time is a challenge to our empathy. It requires historical empathy. How do we get “our heads around” a world that was fundamentally different than our own? It is time – past time – to expand our historical empathy. For example …
Brown Bess, Single Shot Musket, standard with the British Army and American Colonies
When the framers of the US Constitution developed the Bill of Rights, the “arms” named in the Second Amendment’s “right to keep and bear arms” referred to a single shot musket using black powder and lead ball as a bullet. The intention of the authors was to use such weapons for hunting, self-defense, arming the nascent US Armed Forces, and so on. No problem there. All the purposes are valid and lawful.
One thing is for sure and my historical empathy strongly indicates: Whatever the Founding Fathers intended with the Second Amendment, they did NOT intend: Sandy Hook. They did not intend Uvalde, Parkland, Columbine, Buffalo, NY, Tops Friendly. They did not intend some 119 school shootings since 2018. They did not intend a “a fair fight” between bad guys with automatic weapons and police with automatic weapons. The Founding Fathers did not intend wiping out a 4th grade class using automatic weapon(s). They did not intend heart breaking murder of innocent people, including children, everyone as cute as a button.
Now take a step back. I believe we should read the US Constitution literally on this point about the right to “keep and bear” a single shot musket using black powder and lead ball. The whole point of the “strict constructionist” approach – the approach of the distinguished, now late Supreme Court Justice Antonin Scalia, who passed away on Feb 13, 2016 – is to understand what the original framers of the Constitution had in mind at the time the document was drawn up and be true to that intention in so far as one can put oneself in their place. While this can be constraining, it can also be liberating.
Consider: No one in 1787 – or even 1950 – could have imagined that the fire power of an entire regiment would be placed in the hands of single individual with a single long gun able to deliver dozens of shots a minute with rapid reload ammo clips. (I will not debate semi-automatic versus automatic – the mass killer in LasVegas had an easy modification to turn a semi-automatic into an automatic.)
Unimaginable. Not even on the table.
This puts the “right” to “bear arms” in an entirely new context. You have got a right to a single shot musket, powder and ball. You have got a right to a single shot every two minutes, not ten rounds a second for minutes on end, or until the SWAT team arrives. The Founding Fathers did not intend the would-be killer being perversely self-expressed on social media to “out gun” school security staff who are equipped with a six shooter. Now the damage done by such a weapon as the Brown Bess should not be under-estimated. Yet the ability to cause mass casualties is strictly limited by the relatively slow process of reloading.
The Founding Fathers were in favor of self-defense, not in favor of causing mass casualties to make a point in the media. The intention of the Second Amendment is to be secure as one builds a farm in the western wilderness, not wipe out a 4th grade class. I think you can see where this is going.
Let us try a thought experiment. You know, how in Physics 101, you imagine taking a ride on a beam of light? I propose a thought experiment based on historical empathy: Issue every qualified citizen a brown bess musket, powder, and ball. What next?
Exactly what we are doing now! Okay, bang away guys. This is not funny – and yet, in a way, it is. A prospective SNL cold open? When the smoke clears, there is indeed damage, but it is orders of magnitude less than a single military style assault rifle weapon. When the smoke clears, all-too-often weapons are found to be in the hands of people who should not be allowed to touch them – the mentally unstable, those entangled in the criminal justice system, and those lacking in the training needed to use firearms safely.
More to the point, this argument needs to be better known in state legislatures, Congress, and the Supreme Court. All of a sudden the strict constructionists are sounding more “loose” and the “loose” constructionist, more strict. It would be a conversation worth having.
The larger question is what is the relationship between arbitrary advances in technology and the US Constitution. The short answer? Technology is supposed to be value neutral – one can use a hammer to build a house and take shelter from the elements or to bludgeon your innocent neighbor. However, technology also famously has unanticipated consequences. In the 1950s, nuclear power seemed like a good idea – “free” energy from splitting the atom. But then what to do with the radioactive waste whose half life makes the landscape uninhabitable by humans for 10,000 years? Hmmm – hadn’t thought about that. What to do about human error – Three Mile Island? And what to do about human stupidity – Chernobyl? What to do about unanticipated consequences? Mass casualty weapons in the hands of people intent on doing harm? But wait: guns do not kill people; people with guns kill people. Okay, fine.
There are many points to debate. For example, guns are a public health issue: getting shot is bad for a person’s health and well-being. Some citizens have a right to own guns; but all citizens have a right not to get shot. People who may hurt themselves or other people should be prevented from getting access to firearms. There are many public health – and mental health – implications, which will not be resolved here. There are a lot of gun murders in Chicago – including some using guns easily obtained in Texas and related geographies. The point is not to point fingers, though that may be inevitable. The guidance is: Do not ask what is wrong – rather ask what is missing, the availability of which would make a positive different. In this case, one important thing that is missing is historical empathy.
Because the consequences of human actions – including technological innovation – often escape from us, it is necessary to consider processes for managing the technology, providing oversight – in short, regulation. Regulation based on historical empathy. Gun regulation . Do it now.
That said, I am not serious about distributing a musket and powder and ball to every qualified citizen in place of (semi) automatic weapons – this is an argument called a “reduction to absurdity”; but I’ll bet the Founding Fathers would see merit in the approach. There’s a lot more to be said about this – and about historical empathy – but in the meantime, I see a varmint coming round the bend – pass me my brown bess!
(c) Lou Agosta, PhD
PS PS Please send this post or a version of it to your Congressional representatives in the US House and Senate.
Review: How to Think More About Sex by Alain de Botton
Review: How to Think More About Sex by Alain de Botton. New York: Picador Press, 2012; 185 pp.
Alain de Botton is a modern-day version of Nietzsche as stand-up comic. He is a practitioner of the hermeneutics of suspicion and he manages to be funny in doing so. The title itself is funny, for sex is not something we usually want to think more about. Either we cannot stop thinking about it or we want to stop thinking and start performing it (the sex act, that is).
If one stops and considers the matter, for the most part, it is sex that is thinking us, not us actively thinking about it in a reflective way. However, the latter (think about sex in a reflective way) is precisely what de Botton proposes to do and he does an excellent job of it.
The first thought is some direct talk about managing expectations. The expectation that we live in a liberated age (which we do) and therefore we should be comfortable with sex (we are not) is an illusion. We human beings are not wired to be comfortable with sex. Sex is an enormously powerful force “all but incapable of being discretely integrated within civilized society” (p. 6). “Our best hope should be for a respectful accommodation with an anarchic and reckless power” (p. 7).
The pleasures of sex are explored in the initial chapters. In a description of an initial kiss that goes in the direction of soft-core porn and then becomes thoughtfully and alienatingly clinical, de Botton makes the point that what is great about a kiss “stems from the simple realization that someone else likes us quite a lot, a message that would enchant us even if it delivered via another medium” (p. 23). When sex goes just right it represents a reversal of the fall from paradise where Adam and Eve were punished by experiencing shame. The naked, loving couple have a breakthrough in the acceptance of themselves and each other than nakedness makes present.
Eroticism is defined as “the feeling of excitement we experience at finding another human being who shares our values and our sense of the meaning of existence” (p. 44). De Botton notes that sex usually does not last longer than two hours “about the length of the Catholic mass.” This is not quite accurate, but funny.
Regarding physical attraction (“sexiness”), the thinking gets going. We are not supposed to like people based on superficial appearances, but we do. Evolutionary psychology tells us that sexual attraction means we see a healthy parent for our children in the other person as a prospective mate. De Botton prefers Stendhal: “Beauty is the promise of happiness.” Then he imaginatively elaborates, associating physical features with personality states and traits. This person’s cheeks express determination; eyebrows, integrity; lips, intelligence.
For me, one of the high points of this work is de Botton’s invoking Empathy and Abstraction (1907) by Wilhelm Worringer, one of the defining works of the aesthetic application of empathy. The beautiful is that which we need to complete us, and we project aspects of our emotions and personality onto the environment as symbols of totality. We humans need both art and sex to make us whole (p 72).
Since this is not a softball review, I note that de Botton properly pushes back against the overly scrupulous conscience of the sexually inhibited (most of society) when he asserts: “It’s time for the need for love and the need for sex to be granted equal standing, without the need for moral gloss [judgment]” (p. 79). He is absolutely on point in asserting that neither sex nor love should require us to lie in order to get them. Definitely tell the truth – including to yourself. Yet the way sex and love (affection) fall apart is concerning. How does when bring them together?
Here is the debate: Freud pointed out in one of his most powerful and least well known essays (probably because of its obscure title) on “The Most Prevalent Form of Degradation in Erotic Life” (1912) that some men cannot love where/when they desire (sex) and cannot desire where/when the love. They are unable to bring together sexual desire and affection for the other as a person, which unification is a mark of being a psychologically mature adult.
This is the “whore / Madonna” complex (and mostly, but not exclusively, a guy issue) – that he says he loves the mother of his children, but she does not excite him sexually and he can get sexually excited over what is today called a [sexual] “hook up” with someone he does not know. As noted, today this is a phenomenon that is still mostly male but is expanding its occurrence among woman who aspire to use sex to get power in relationships. Note whether this tactic is effective is a further point of debate.
In the middle section under problems, de Botton covers some of the same ground as Ester Perel in Mating in Captivity (2006) including libido dampening circumstances: Marriage tends to involve “[…] the running of a household and the raising of children, tasks that often feel akin to the administration of a small business and that draw upon many of the same bureaucratic and procedural skills, including time management, self-discipline, the exercising of authority and the imposition of rules upon recalcitrant others” (p. 90). Here de Botton explicitly invokes the above-cited split between desire and affection: “Sex may sometimes be just too private an activity to engage in with someone we know well and have to see all the time” (p 92).
The recommendation? Since most people would not be comfortable getting a third party to have sex with the spouse while they watched – the idea literally to witness about the spouse what the other finds stimulating – de Botton recommends a stay at a fancy hotel. More substantially, the recommendation is there to do to the spouse what Manet did to a lowly bunch of asparagus – see the bundle in a new way, overlooking its commonness, and making it into a work of art. Love is sublimated sexuality; sex as art. As Bob Dylan wrote, love is another four-letter word. This is hormones all the way down.
As someone who has published extensively on empathy, this reviewer swallowed hard to read de Botton associate empathy with impotence: “Impotence had its origins in the increase in empathy attendant on the promotion of the Golden Rule (p. 109). “Impotence is at base, then, a symptom of respect, a fear of causing displeasure through the imposition of our own desires […]” (p. 111). The solution according to de Botton? Don’t be unempathic. Don’t be unkind. Employ a psychopharm intervention. Take the Viagra, even if you have furtively to swallow it in the bathroom. You can’t make this stuff up.
I have to acknowledge that the caveman approach to sex has significant limitations. For my part, de Botton, who rarely misses a beat, fails to mention that the real turn on is turning on one’s partner. We desire the other’s desire. I want you to want me. And for that one needs empathy.
If the molten cauldron of libido needed to have really great sex is siphoned off by kindness, for others, the opposite is the case. Partners hurt one another’s feelings in relatively minor ways, grievances and resentments, build up, of which the individuals are barely aware. People are aggrieved at not getting the recognition, acknowledgement, dignity, respect, or empathy they deserve. No empathy; no sex. Too much empathy? Not enough empathy? Sometimes we humans just can’t get a break. Finding a balance is challenging.
Therefore, I propose an alternative point of view to de Botton. You know how gray is the new black in fashion? Well, empathy is the new love. It is what people are really hungry for – another person who “gets you” as the possibility you authentically are. That is the ultimate turn on. Still, a wide spectrum exists between tenderness and Tarzan, between empathy and ejaculation. Therefore, if that involves putting on an animal skin loin cloth (only to take it off at the right time), definitely consider the possibility. Never was it truer, “when you’re hot, you’re hot; when you’re not, you’re not.”
The recommendation? “In a perfect world, all couples would be visited by a psychotherapist on a weekly basis […]” (p. 119). The therapy? Here we get to the title of How to Think More About Sex: “The idea persists that too much thinking might make it impossible for us to feel – as if it weren’t already quite plainly apparent that a large and constant amount of thinking may be the only thing that can keep us from destroying each other (p. 121).
And what indeed should we be thinking? “[…] Our culture locates the primary difficulty of relationships in finding the ‘right’ person rather than in knowing how to love a real – that is, a necessarily rather unright – human being” (p, 121).
De Botton raises the point that failure to have regular sex may not be pathological (p. 105). He Botton has little use for internet porn, and his position is clear. “The entire internet is in a sense pornographic, a deliverer of a constant excitement that we have no innate capacity to resist, a seducer that leads us down paths that for the most part do nothing to answer our real needs” (p. 133). He considers internet porn in the same category as alcohol and street drugs, undermining “our ability to endure certain kinds of suffering which we have to experience if we are to direct our lives properly” (p. 130).
Regarding adultery, de Botton tries to illuminate this blind spot of hypocrisy and broken word through a mixture of cynicism, resignation, and reverse psychology. In so many words, he says people who are able to be faithful over the long term should get a major award or at least a medal. It is a high bar, faithfulness, involving significant sacrifice for their love and for their children. Keeping one’s word is rarely easy. He does not mention that lack of real opportunity saves most people from slipping up. The fervent prayer “Lord, lead me into temptation” remains unanswered. He counsels forgiveness for those who stray from the path of faithfulness, also acknowledging how hard it can be to get to forgiveness.
Alain de Botton’s How to Think More About Sex is a concise book of a modest 179 pages, and a quick read. It is fully buzzword compliant, covering evolutionary psychology, which gets cited as accurate enough but not that helpful interpersonally, fetishes (with reference to Richard Krafft-Ebing Psychopathia Sexualis (1886)), evolutionary psychology, Michelangelo Caravaggio’s “Judith beheading Holofernes” (1599), Freud, Masters and Johnson on Human Sexual Inadequacy (1970) (with an illustration of a penis), and a draft of a deeply Schopenhauerian marriage contract (p. 162). (By the way, Schopenhauer never married.)
De Botton blames the bourgeois ideology that the best and only reason to get married is for love. And he counsels changing the vows: “I promise to be disappointed by you and you alone. I promise to make you the role repository of my regrets, rather than to distribute them widely through multiple affairs and a life of sexual Don Juanism [the male-centric perspective is hereby noted]. I have surveyed the different options for unhappiness, and it is you I have chosen to commit myself to” (p. 162). In case of the breakdown of adultery, the betrayed partner may justifiably complain: “I was relying on you to be loyal to the specific variety of disappointment that I represent” (p. 162). Finally, with Alain de Botton’s How to Think More about Sex, I did. I also both laughed and cried, and you will too.
(C) Lou Agosta, PhD and the Chicago Empathy Project
Left stranded when the music stops: What to do about the shortage of talk therapists actually available
An article in the Washington Post by Lenny Bernstein: “This is why it is so hard to find mental health counseling right now” (March 6, 2022) struck a chord with many readers.[1]
The article begins by describing an individual in the Los Angeles area who said she was willing to pay hundreds of dollars per session and called some twenty-five therapists in the area but was unable to find an opening. The person willingly shared her name in the article. Be careful not to blame the survivor or victim – the report is credible – and she maintained a spreadsheet!
One of the main points of the article is that after several years of pandemic stress prospective clients and patients are at the end of their emotional rope and providers (therapists) are over-scheduled and burned out too. No availability.
The problem is systemic. There seems to be no bottom in sight as regards the opportunistic behavior of insurance companies, the lack of behavioral health resources, and the suffering of potential patients. The WP article goes on to document other potential patients with significantly less resources who cannot even get on a wait list. The article documents third party insurance payers whose “in network” providers are unwilling to see prospective patients due to thin
reimbursements from the payer – once again, the individual is unable to get on a wait list or get help urgently needed; supply side shortages are over the top in the programs that train psychiatrists, a specialty in medicine. Psychiatrists, when available, are most often interested in lucrative fifteen-minute medication management sessions, but unless they are “old school” and were psychoanalytically trained in the “way back,” they are rarely available for conversations. This all adds up to a crisis in the availability of behavioral health services.
This leads to my punch line. Often time depression, anxiety and emotional upset are accompanied by negative self-talk, shaky or low self-esteem. One reaches out and asks for help but instead has an experience of powerlessness that is hard to distinguish from the original emotional disequilibrium. The conversation spins in a tight circle – “maybe I deserve it – no I don’t – this sucks – I suck – help!” The person resigns himself to alife of gentile poverty, thinking she or he is not worthy of financial well-being. The prospective patient is left aggrieved. This grievance is accurate and real enough in context, but it is hard to identify what or who can make a difference. Nevertheless, there is no power in being aggrieved. One still has to do the thing the person in distress or with shaky self-esteem is least inclined to do – invest in oneself because one is worth it!
I have spoken with numerous potential and actual clients who pay a lot of money for health insurance. However, when they want to use the insurance for behavioral health services, they find the insurance is not workable. Not usable. The service level agreement is hard to understand, and having a deductible of a couple of thousand dollars is hard to distinguish from having no insurance at all. If the client goes “in network,” the therapists are unresponsive or inexperienced. If the client goes out of network, the therapists are often more experienced and able to help, but onerous deductibles and copays rear their heads. Why don’t the experienced therapists go in network? There are many reasons but one of them is that the insurer often insists the therapist accept thirty cents on the dollar in compensation, and some therapists find it hard to make ends meet that way. In short, as a potential patient, you think you have insurance, but when it comes to behavioral health, you really don’t.
My main point is to provide guidance as to some things you can do to get the help you need with emotional or behavioral upset and do so in a timely way. Turns out one has to give an informal tutorial on using insurance as well as on emotional well-being. I hasten to add that “all the usual disclaimers apply.” This is not legal advice, medical advice, insurance advice, cooking advice or any kind of advice. This is a good faith, best efforts to share some brain storming and personal tips and techniques earned in the “college of hard knocks” in dealing with these issues. Your mileage may vary.
Nothing I say in this article should be taken as minimizing or dismissing the gravity of your suffering or the complexity of this matter. If you are looking for a therapist or counselor, it is because you need a therapist or counselor, not a breach of contract action against an insurance company. You want a therapist not a legal case or participation in a class action law suit, even if the insurance contract has plenty of “loop holes.” For the moment, the latter is a rhetorical point only.
When a person is anxious or depressed or struggling with addiction or other emotional upset, being an informed assertive consumer of behavioral health services is precisely the thing the person is least able to do. “I need help now! Shut up and talk to me!”
Notwithstanding my commitment to expanding a rigorous and critical empathy, here’s the tough love. Without minimizing your struggle and suffering, the thing you least want to do is what you are going to have to try to do. If one is emotionally upset, the least thing you want to do is be an assertive consumer of services designed to get you back your power in the face of emotional upset or whatever upsetting issues you are facing.
The recommendation is to speak to truth to power and assertively demand an “in network” provider from the insurance company or invest in yourself and pay the private fee for an experienced therapist whom you find authentically empathic, then you already be well on the way to getting your power back in the face of whatever issues you are facing.
If your issue is that you really don’t have enough money (and who does?), then you may need to get the job and career coaching that will enable you to network your way forward. An inexpensive place to start is The Two Hour Job Search by Steve Dalton. Highly recommended. Note the paradox here – the very thing you do not want to do keeps coming up. You definitely need someone to talk to. Once again, the very things with which you need help are what re stopping you from getting help
The bureaucratic indifference of insurance companies is built into the system. The idea of an insurance is a company committed to making money by spreading risk between predictable outcomes and a certain number of “adverse” [“bad risk”] events. It is not entirely fair (or even accurate) but by becoming depressed or anxious (and so on), you are already an adverse event or bad risk waiting to happen. You may expect to be treated as such by most insurance companies.
In a health insurance context, the traditional model for the use of services is a broken arm or an appendicitis (these are just two examples among many). You definitely want to have major medical insurance against such an unfortunate turn of events. Consider the possibility: Buy major medical only – and invest the difference saved in your therapy and therapist of choice.
But note these adverse medical events are relatively self-contained events – page the surgeon, perform the operation, take a week to recover or walk around in a sling for awhile. The insurance company pays the providers (doctors and hospitals) ten grand to thirty grand. That’s it. With lower back pain, headaches, irritable bowel syndrome, autoimmune disorders, it is a different story. These are notoriously difficult to diagnose and treat. Yet, modern medicine has effective imaging and treatment resources that often successfully provide significant relief if not always complete cures for the patient’s distress in these more complex cases.
Consider similar cases in behavioral health. Start by talking to your family doctor. Okay, that is advice – talk to your family doctor for starters. Front line family doctors have the authority – and most have the basic training – needed to prescribe modern antidepressants (so called SSRIs), which also are often effective against anxiety, to treat simple forms of depression and anxiety due to life stresses such as an ongoing pandemic, job loss, relationship setbacks.
Even though I am one of the professionals who has consistently advocated “Plato not Prozac,” I acknowledge the value of such psychopharmacological interventions from a medical doctor to get a person through a rough patch until the person can engage in a conversation for possibility and get at the underlying cause of the emotional disequilibrium. Note this implies the person wants to look for or at the underlying dynamics. This leads us to the uncomfortable suggestion that it is going to take something on the part of the client to engage and overcome the problem, issue, upset, which is stopping the client from moving forward in her or his life.
There is a large gray area in life in which people struggle with relationship issues, finances, career, education, pervasive feelings of emptiness, chronic emotional upset, self-defeating behavior in the use of substances such as alcohol and cannabis (this list is not complete).
A medical doctor or other astute professional may even provide a medical diagnosis when the interaction of the person’s personality with the person’s life falls into patterns of struggle, upset, and failure. Insurance companies require a medical diagnosis. One thinks of such codable disorders as adjustment disorder or personality disorders (PD) such as narcissistic, histrionic, schizoid, antisocial, or borderline PD. These are labels which can be misleading and even dangerous to apply without talking to the person and getting to know them over a period of time. It’s not like the Psychology Today headline – top three ways to know if you are dating a narcissist. I am calling “BS” on that approach.
Nevertheless, if after a thorough process of inquiry, some such label is appropriate (however useless the label may otherwise be except for insurance purposes), then the cost will be right up there with “fixing” an appendicitis – only you won’t be able to do it in a single day – and it won’t be that kind of “fix”. An extended effort and of hard to predict duration must be anticipated, lasting from months even to years. This is not good news, but there are options.
My commitment is to expanding a rigorous and critical empathy in the individual and the community. I consider that I am an empathy consultant, though at times that is hard to distinguish from a therapeutic process and inquiry into the possibilities of health and behavioral well-being. Therefore, and out of this commitment, I have a sliding scale fee structure for my consulting and related empathy services. People call me up and say “I make a lot of money, and want to pay you more.” Of course, that is a joke. I regularly hear from prospective clients whose first consideration is financial. They do not have enough money. I take this assertion seriously, and I discuss finances with them. Between school debt and the economic disruptions of three years of pandemic, people are hurting in many ways including financially. One must be careful NEVER to blame the victim or survivor.
The best way for such financially strapped individuals to go froward is to find an “in network” provider. Key term: in network. But we just read the Washington Post article that furnishes credible evidence such networks are tapped out, in breakdown, not working. Those that are working well enough often deal with the gray area of emotional upset and life challenges by moving the behavioral health component to a separate corporate subsidy at a separate location to deal with all aspects of behavioral health. (See above on “bad risk.”) When I had such an issue years ago, I had to search high and low to get the phone number, web site, or US postal address. You can’t make this stuff up. This is because ultimately, the issues that come up are nothing like an appendicitis or even hard to diagnose migraines. Moving the paying entity to a corporate subsidy is also a way that the insurance company can impose a high deductible and/or copay by carving out that section of the business and claims processing. There are other reasons, too, but basically, they are financial.
You may be starting to appreciate that many health insurance contracts are not really designed to provide behavioral health services (e.g., therapy) the way they are designed to address a broken leg or appendicitis. There is a way forward, but it is more complex (and expensive in terms of actual dollar, though not necessarily time and effort). I will address this starting in the paragraph after next, because, sometimes in the case of behavioral health, people who have insurance do not really have useable, workable behavioral health insurance. For all intents and purposes, they think they have insurance, but, in this specific regard, they have a piece of paper and a phone number that is hard to find. I hasten to add I am not recommending going without major medical health insurance, inadequate though it may be in certain respects.
This brings us to those individuals who decide to go without insurance. What about them? Such individuals choose to take the risk. They are living dangerously because if they do break an arm or incur an appendicitis, then they are going to have another $30K in medical debt [this number is approximate and probably low], along with a mountain of school debt, credit card debt, and bad judgment debt (this list is not complete). These good people need insurance, not so much to get therapy – because, as the accumulating evidence indicates, it really doesn’t work that way – as to be insured against a major medical accident. Many people are not clear on this distinction, but I would urge them to consider the possibility.
I spoke with this one prospective client who began with a long and authentically moving narrative that she did not have enough money and could not afford therapy. This is common and not particularly confidential or sensitive. As part of a no fee first interview to establish readiness for therapy, I acknowledged her courage in strength in reaching out to someone she did not really know to get help with her problems. I acknowledged that one of her problems was she did not have enough money. A bold statement of the obvious. I asked if there was anything else she wanted to work on. It turns out that she was a survivor of a number of difficult situations and would benefit from both empathy consulting, and talk therapy – and I might add job coaching. Here’s the thing – when a person is hurting emotionally, they do not want to look for another job – or a better job that pays more money. But one just might have to do that, at least over the short term, with someone who can provide that kind of guidance to those who are willing. I encouraged her to be assertive with her insurance company and I heard she found someone in network at a low rate.
And if you are a therapist who believes such job coaching compromises the purity or neutrality of the therapy, I would agree. However, never say never. In the aftermath of World War I, when the victorious allies maintained a starvation blockage on Germany and Austria even into 1919, Freud (that would be Sigmund) was reportedly seeing a client in exchange for a substantial bag of potatoes. I have no facts – none – but I find it hard to believe they were discussing matters pertinent to individual and collective survival. So far no one has offered me a bag of potatoes (I am holding out for a quantity of olive oil and basil to make pesto), but see the above cited article from the Washington Post.
We circle back to where we started. If the individual named in the Washington Post article has not yet found a therapist, then I believe there are many in the Chicago area would welcome the opportunity to make a difference for her. She has a budget for therapy, she says. If you have a budget, the work goes forward. It can be confronting and difficult to contemplate, but if you were buying a car, you would look at your budget. If you were planning a vacation, you would think about your vacation budget. If you were thinking of going back to school, you would look at your education budget. You get the idea. What is your budget for empathy consulting, counseling, talk therapy, cognitive retraining, life coaching, or medication management services (this are all distinct interventions, appropriate in different circumstances)? Zero may not be the right number. Just saying. Of course, if the client is in LA and the empathy consultant is in Chicago, it would be a conversation over Zoom. That starts a new thread so I may usefully clarify that I prefer to meet with people in person – the empathy is expanded in person – but the genie is out of the bottle and online can be good enough in some circumstance. (See my peer reviewed article “The Genie is Out of the Bottle”: https://bit.ly/37vxJ0L.)
The insurance system is broken as regards behavioral health (as evidenced by the WP article). There is a vast gray area of people with modest emotional disregulation who genuinely need help. These are not only the “worried well,” but people whose understandable lack of assertiveness in navigating an indifferent (and it must be said unempathic) bureaucracy leaves them high and dry with their moderate but worsening emotional, spiritual, and behavioral upsets. These people deserve help, and are entitled to it even under the specific terms of their insurance contracts. Indeed they are entitled to help even if they do not have insurance, though the revenue model is simpler in that case, though not less costly.
The insurance company has been unable to make money off of this gray area – therefore, the insurance company does what it does best – it turns to making money off of you. But you need health insurance against a major medical event or accident. You want a therapist, not a breach of contract case in small claims court (where the small claim often goes up to $100k). Therefore, it does little good to document having called ten or twenty-five in network providers with no result. Or does it? You – or a class action attorney firm – have a case for breach of contract. Go out of network and forward the invoices to the payer by mail with a tracking number, requesting that the full therapy fees be treated “in network” for purposes of reimbursement, and, therefore, no or low deductible and copay. Of course, one would have to have funds for that upfront, and lack of money is where this circle started. Back to expanding one’s job search skills?
This is crazy – and crazy making behavior – though only as a function of a system that is crazy. You see the problem. I’ll bet dollars to donuts that the insurance payer, when confronted with an actual summons to small claims court, would then find you a therapist – of course, the therapist might be relatively inexperienced or someone who (how shall I put it delicately?) is less motivated than one might hope. Thwarted again!
As I wrap up this post, it occurs to that while it would be crazy for an individual to seek legal redress – it might even be “acting out,” there might be a basis for an enterprising law firm to establish a system wide “class action” for breach of contract. This will not solve your problem of getting help in the next two weeks, but it might be a necessary step to benefit the community. You know the insurance company has the money!
As noted above, your grievance in being over sold unworkable behavioral health insurance may be [is] accurate and real. Nevertheless, I am sticking to my story: the guidance: there is no power in being aggrieved. You still have to do the thing the person in upset or with shaky self-esteem is least inclined to do – dig down, including into your pockets, and find self-confidence – or enough self-confidence for the moment – and invest in yourself because you are worth it!
The one minute empathy training – runtime is actually five minutes, but a personal introduction is included: https://youtu.be/747OiV-GTx4
[1] https://www.washingtonpost.com/health/2022/03/06/therapist-covid-burnout/
Lou Agosta, Ph.D., Listening With Empathy 