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Resistance to Empathy and How to Overcome it (Part 1: Organizational Resistance to Empathy)
You don’t need an expert to practice empathy
Every parent, teacher, doctor, social worker, sales person, person with customers, first responder, consultant, neighbor, or taxi driver already knows a lot about empathy. They would not be successful, much less survive, if they did not practice empathy. You may need a license to be a barber and cut hair. However, outside totalitarian state, no one can require that you have a license to do what comes spontaneously to the vast majority of human beings—be empathic. However, an expert can be helpful in clarifying distinctions, providing tips and techniques, and modeling the empathy you want to get or apply and expand.
Parents are naturally empathic towards their children; teachers, towards their students; medical doctors, towards their patients; business people, towards their customers, consultants towards their clients, and so on. Even if a person is clumsy and does not get empathy quite right, people can’t stop doing it. Yes, that’s right—people can’t stop being empathic; but then fear stops them—fear of experiencing vicariously another person’s pain, struggle, conflict, or suffering—and a breakdown occurs in their empathy. There must be something wrong here! Blame starts flying around. They blame themselves. They blame the other person. They blame empathy.
Even if doctors are trained to “tune down” their spontaneous empathy until it becomes “detached concern”—and good reasons exist for doing that at times—empathy naturally breaks through, and they often relate authentically to their patients as one human being to another in spite of themselves.[i]
The really useful thing is that in learning to contract one’s empathy, one is also learning expand it, because one is learning to regulate and manage empathy. Contracting one’s empathy also means being able to expand it. “Dialing down” empathy also means being able to “dial up” empathy.
“Dialing down” empathy does not mean “stop listening,” “be unkind,” “blame,” “make wrong,” “reject,” “be hostile,” “use devaluing speech,” or “feign thoughtlessness.” Such a response would be absurd.
There is a sense in which a feeling may be socially appropriate or inappropriate—for example to laugh at a funeral when nothing is funny—feelings are valid in themselves in that they always are what they are.
A feeling may be an inarticulate judgment—fear being the judgment that one should run from danger—especially if a mountain lion is coming around the bend. The fear is an absolute given in the moment.
One may wish that one felt differently than one does in fact feel in the moment; but that one feels a certain way is an absolute given.
The best way to turn fear into an out-an-out panic attack is to say to oneself: “This (fear) should not be!” But of course it is, so that means what? One has lost control. Panic!
The recommendation? Accepting the feelings as what’s so does not make an unpleasant feeling any easier to bear, but it takes away its power, drains the upset out of it, and gives one space to be in equilibrium with oneself again. Thus, radical acceptance of the feeling is an effective method of “dialing down” one’s empathy.
Most people are naturally empathic, but they lack practice. They set about practicing empathy, but are clumsy. Or they had a bad experience in relation to their own empathy or someone else’s (lack of) empathy. They develop a “flinch reflex” when it comes to practicing empathy. For such individuals, resistance to empathy replaces their spontaneous empathy. Most people use empathy every day, and do not need an expert to tell them what it is. Olympic athletes get a coach, but it is not because they are not good at what they do. They are good at what they do; and are striving to get to the next level of excellence. Few people claim to be really good at empathizing. Those persons who are practiced in empathy can be useful coaches in helping one to clarify definitions, engage the hard cases, and distinguish how to transform breakdowns of empathy into breakthroughs that make a difference.
Using empathy—practicing empathy—sometimes means being used by empathy. Yes, empathy uses us.
“Being used by empathy” means that the person has trained in being empathic, so that the person has a level of mastery that allows the person to be empathic (or not) without thinking too much about it. Empathy has become practiced, habitual, and automatic.
There’s what we know we know about empathy. There’s what we know we do not know about empathy and hope to find out. Where did the word come from? What are mirror neurons anyway? How does one expand one’s empathy?
Finally, there is what we do not even know we do not know about empathy. The third area is where this book and its training operates—what we do not even know we do not know: our blind spots about empathy; our vulnerability, shame, and cynicism in relating to others; and our resistance to empathy.
Empathy requires that one get “up close and personal” with other people. Other people can be notoriously difficult, irritable, dishonest, manipulative, apathetic, too pushy, or contrary. Other people resist being on the receiving end of empathy, because being understood makes them feel vulnerable.
If someone understands me, really understands me, then he can use what he understands about me to take advantage of me. Now an authentically empathic person would not do that, but the world is not known for being filled with authentically empathic people.
Well-intentioned persons sometimes simply misunderstand what empathy is and are resisting something else that they happen to call “empathy.” They mistake the breakdown of empathy in emotional contagion, conformity, projection, distortion, mind reading, or lack of responsiveness, for empathy proper, and throw out the baby with the proverbial bath water. The empathy lesson in confronting resistance to empathy is direct: remove the resistance to empathy, and empathy comes forth, develops, and blossoms. Empathy expands.
Overcome resistance to empathy: empathy expands
Another person’s blind spots are easy to see, but one struggles to catch a glimpse of one’s own. Thus, one of my own blind spots about empathy comes into view, albeit in my peripheral vision. When I do not get my way, I have the thought that the other person (or the world) is unempathic. This is of course absurd and self-serving, though, heaven knows, empathy is unevenly distributed in the world. The empathy lesson? Wherever there is empathy, can narcissism be far away? (No.) Thus, I clean up the thought—give it up, distinguish it as not helpful, let it go. But no matter how may times I give it up, the next time I am frustrated, it seems like there is that thought again, coming into view like the grin on the Cheshire cat. Only now it becomes an inside joke, and a challenge to earn my empathic wings everyday.
This lesson is easy to express, hard to do. The devil is in the details. One has to descend into the hell of one’s empathy breakdowns in order to emerge from the refiner’s fire of self-inquiry with renewed commitment to empathy, relatedness, and community. This sounds too hard. No one said it would be easy.
How to start? One begins by introspecting. Acknowledging one’s own lack of integrity and inauthenticity in the matter of empathy. Like the labors of the mythical hero Hercules, there is a whole lot of shoveling of manure to be performed.
Cleaning up broken interpersonal relationships is on the agenda. Repairing integrity outages and inauthenticities is in order. Empathy training includes the requirement to go out into the world of one’s relations with other persons and engage and practice.
The very idea of resistance to empathy inspires resistance. The idea of resistance to empathy requires motivation.
What could that even be? Resistance to empathy seems to make no sense. It sounds like resisting motherhood, puppies, or apple pie.
The idea that some people would resist empathy is surprising. Very surprising. What’s not to like about empathy? A great deal it seems. Even within this way of talking, appearances can be deceptive. Puppies make a mess on the new carpet. Apple pie is delicious, but it makes one fat. Mothers are wonderful people. The human race owes its existence to those who are mothers both individually and as a community; but motherhood is a damn tough job, not withstanding its many rewards. Mothers require a lot of support. Volunteers?
In general, receiving empathy is like getting a gift; providing empathy requires effort. Getting empathy is a benefit. Providing empathy requires listening to the other person, attending to one’s introspective reaction to the other person, managing the increase in tension, living with the uncertainty of being open to the other person, being vulnerable, and risking misunderstanding. This is why providing empathy inspires resistance. It requires work.
On the other hand, receiving empathy from a committed listener has been compared to sinking back into a warm bath. It is relaxing. It reduces stress. It is restorative of one’s emotional equilibrium. However, even in a one-on-one conversation, receiving empathy sometimes feels like being publicly acknowledged and recognized at a banquet. It has its uncomfortable side.
It is not always easy to be explicitly acknowledged and recognized for one’s contribution. One may feel ambivalent about being exposed and vulnerable. So even receiving empathy, though properly regarded as a benefit, has its conditions and qualifications; and some people are made painfully self-conscious by being acknowledged.
Whether one is giving empathy or receiving it, empathy has its dark side. If one is committed to giving empathy—being empathic—one is vulnerable to burnout, empathic distress, or “compassion fatigue.” If one is on the receiving end of empathic receptivity, though a restorative experience, one is still exposed in one’s potential weaknesses and limitations. One feels vulnerable to misunderstanding by the other person, to whom one has exposed oneself emotionally.
At a deeper level, resistance to empathy lives in our individual and collective blind spots about our dear self. Where there is empathy, can narcissism be far away? “Narcissism” is a way of relating to oneself. The mythical Narcissus was an attractive young man. He was so enamored of his own reflection in the mirror-like surface of the pond—this was before the invention of “selfies”—that he did not see the dangers of his surroundings. In different versions of the myth, Narcissus either fell into the water, drowning in his own image of himself, or he was consumed—metaphorically eaten—by the lion of his narcissistic desires, who also frequented the watering hole.
The empathy lesson of the myth of Narcissus? Empathy requires de-emphasizing “the dear self.” Even for someone committed to giving empathy such a de-emphasis of self-love is not automatic. When the empathy being delivered includes recognition, people struggling with self-esteem issues—either too much or too little—find it challenging just to accept the acknowledgement. “Naw, it wasn’t nothing—just doin’ my job.” It is not easy to be acknowledged, and therein lies resistance to empathy, too. Though receiving empathy feels good, it is not easy to open up to another person and acknowledge one’s personal issues, sufferings, sources of shame, or struggles.
In every instance of resistance to empathy, the empathy lesson consists in identifying, engaging, reducing, managing, or eliminating, the resistance to empathy by interpreting the resistance; driving out cynicism, shame, guilt (and so on); saying what is missing the presence of which would make a difference (such as respect for boundaries or contribution); and being open to the possibility—of expanded empathy.
When the resistance is reduced, empathy has space to expand, which it does so spontaneously as well as through providing explicit practices, tactics, strategies, and training.
The qualities that make organizations successful are not always the qualities that enhance their empathy. I am so bold as to assert this generalization applies whether the institution is a tax paying public one, listed on the stock exchange, or a nonprofit, community organization. Whether the corporate mission is to deliver value in manufacturing automobiles or to serve the community by collecting and distributing whole human blood to sick people, the ultimate truth is: no money, no mission.
Yet to say that the purpose of one’s business is to make money is like saying the purpose of life is to keep on breathing. Well, okay. The two are closely related. Definitely, don’t stop breathing. But somehow “don’t stop breathing” is not very useful as life guidance; and, likewise, “make money” is not a useful business strategy.
The ongoing process of living—or doing business—should not be confused with the purpose, vision, strategy, and meaning of the activity in the direction of excellence, whether in business or the community.
In most successful organizations, expanding revenue is a result of a successful strategy—applications and implementations that deliver value—and satisfy the demands of the customers, employees, and stakeholders. The expanded revenue is the effect of getting the vision and implementation just right, not the cause of it.
Successful enterprises of all kinds have to handle navigating an intricate, complex network of rules assigned by government, law enforcement, taxing authorities, and non-governmental special interest groups. Business and nonprofit enterprises must contend with competing organizations that assert and authentically believe that they can provide the product or service at lower cost or higher quality. Within the enterprise itself, the organization must balance the personalities of the leaders, individual contributors (workers), and stake-holders, who make up the organization.
An inherent challenge exists in building organizations and crafting an administrative structure that actually functions; and then getting the administrative structure—the bureaucracy—to act in a responsive and balanced way to customers, employees, and stake-holders.
Economies of scale that require fitting people into functions that can be substituted for one another to increase efficiency rarely expand empathy, because empathy consists in recognizing differences in individual contributions.
Hear me say it, and not for the last time: the things that make us good at business, including the corporate transformation of American medicine and education, do not always expand our empathy. What to do about it? The battle is joined. The recommendation?
Let your customers, constituents, or stake-holders train you in empathy: Realize that if you do not respond empathically, the customers are just going to go quietly to the competitor that does. Empathy is good for business. If the customer has a complaint that he is having trouble expressing, then use one’s listening skills to get to the bottom of things.
If the customer expresses anger, know that empathy is one of the best methods, bar none, of deescalating conflict and soothing anger. “Gee, it really does sound like you have not been well treated. Let’s see what we can do to make things better” [or words to that effect].
Still, I do not know of a single organization that as of the date of publication of this book, when making decisions, serving customers, documenting complaints, closing sales, managing conflicts of interest, asks: “What would the empathic response be?”
To be sure, aspects of the empathic response are included in such common factors as “be respectful to customers,” “be helpful to clients,” “keep one’s agreements,” “strive to deliver value.” Empathy is already in the mix, and many customers are willing to pay a premium for empathic services even if they do not use the word “empathy.”
The astute businessperson, committed to expanding the enterprise, knows that “if you want to gather honey, do not knock over the bees’ nest.” This is distinct from empathy, but not by much. Thus, the task is to nurture the seeds of empathy already present in abundance, but lying in hiding in cynicism and denial, while making the case that smart organizations build and deliver value empathically.
The legendary Marshall Field, one of the inventors of the department store, on which the sun is now setting, and a kinder, gentler robber baron of capitalism, is famously quoted as saying, “Give the lady what she wants.” It made Field rich, and his workers well off. It is perhaps a sign of the times that Field’s was purchased by Macy’s some years ago, which has struggles of its own in a world in which retail, having been “Amazoned,” is not what it used to be. So the tenuousness of the market value of empathy can be measured by the mark down of the once storied Field’s Enterprises in the face of Internet shopping.
An alternative redescription of the fire sale of Marshall Field’s flagship stores is that individualized, personalized, customized one-on-one service has moved to the ultimate free market, the Internet, once again, disintermediating the disintermediators. I would not rule out expanded empathy in online cyberspace, but, even allowing for the convenience of shopping naked, it is a work in progress.
Even in mild and efficient bureaucracies, people misuse organizational rules and paper work to create resistance to empathy. Passing the buck, “Not my job,” “I’ll have to get back to you,” “We received no such request,” “I don’t know, and I can’t tell you when,” are common responses. Bureaucrats (which used to mean “office worker,” but is now a devaluing term) address such pseudo-answers not only to customers, but also to their coworkers and managers.
Resistance to empathy uses organizational rules and regulations to build protective walls, instead of teamwork. Without concern for the other person, bureaucracy unwittingly creates obstacles that prevent workers from being present with one another.
Mutually implementing and contributing to agreements with the organization and one another is not a priority. Perpetuating the bureaucracy is. Managing permissions and gaming the system occur to avoid work, rework, and overwork. The threat of uncompensated overtime and overwork consumes the energy required to get the job done.
People automatically and unwittingly fall into resistance to empathy, exploiting the tendency to be territorial.
The organization itself can show up as the unempathic authority figure—like the unempathic parent, who leaves the child feeling devalued, depressed, and de-energized. In response, an individual pushes back against the organization and its rules, disagreeing and speaking truth to power.
Rarely does the organization respond empathically to the individual, but rather urges the individual to conform. The individual asks for an accommodation. “Power” exhorts the individual to comply. “Power” says, “I did not make up the rules—I just enforce them.”
The individual states that the organization exists to serve the stake-holders, not to perpetuate its own rule-making. But rule-making has a way of becoming habit forming, if not addictive. Whenever a problem, issue, or breakdown occurs, the tendency is to try to formulate a rule to cover the new case. If the individual continues for any amount of time in a state of non-compliance, then “power” tends to experience a loss of authority, which is deeply threatening and unacceptable to “power.” Power escalates efforts to force compliance. Power imposes sanctions, increasing the cost to the individual. Empathy struggles to make a difference and be heard.
Compliance is definitely trending. This is the age of compliance. And there is nothing wrong with compliance as such. Stop on red; go on green. Yet sometimes so many “shoulds” exist that doing one’s job can end up on a slope of diminishing returns. Filling out the required paperwork takes an increasing percentage of the workday.
For example, some people train to become nurses because they care about other people, and they want to take care of them and their health. However, when virtually every patient encounter has to be documented to satisfy compliance regulations, then an eight-hour workday includes hours of electronic documentation. Many nurses are saying, “This is not what I signed up for.” Engagement—a synonym for empathic nursing encounters—struggles for space to make a difference.
“Compliance” includes conforming to acceptable boundaries and limits. No one is saying break the rules. No one is saying disregard boundaries. Rather one is saying relate to rules and boundaries empathically. But what does that mean? Even if the light is green, look both ways for emergency equipment or an inattentive driver running the light. Don’t be dead right. And as applied to empathy?
Empathy is about traversing boundaries between individuals. But these include not only boundaries between the self and the other, but boundaries between those in a position of authority and subordinates, between insiders and outsiders in communities, and between those who are insiders and those who feel left out—or are actually marginalized and have become invisible.
Humor and empathy versus cynicism
Cynicism and denial are the enemies of empathy. The empathy lessons are simple: Empathy up, cynicism down. Humor up, empathy up. Yet in the face of life’s challenges, setbacks, and struggles to survive, everyone gets cynical on a bad day.
Ground zero of cynicism and humor is Scott Adam’s Dilbert cartoon. It is wickedly funny, because it expresses more than a grain of truth about dysfunctional, anti-empathic organizations.
In one classic example, the pointy-haired boss says that from now on the organization will assign job functions based on the Myers-Briggs Personality Test (MBPT). For those readers who may not know, the MBPT is the test that distinguishes introversion and extroversion, thinking and feeling, and related categories. The boss continues: “For those of you who do not have a personality, one will be assigned by the human resources department.”[ii] I must say that I am deeply ashamed of myself—I can’t stop laughing.
In humor, stress and psychological tension are created by violating a standard—saying people in corporate cubicles have no personality—and then the stress is released in laughter by the mechanism of the joke such as a pun, double meaning, or violation of expectations.
Humor is closely related to empathy in that both humor and empathy cross a boundary between the self and the other. However, unlike empathy, in which the boundary crossing occurs respectfully, with acknowledgement of the other person’s contribution or struggle, and with recognition of humanity, in humor the boundary between self and other is crossed with aggression, put down, or (in other cases) sexuality. The rule? The more objectionable the joke is, the funnier it is. The put down, “If you do not have a personality, one will be assigned by HR” is indeed wickedly funny; but it is also deeply debunking of the corporate world (and shaming of the individual), in which people come to feel like a gear in an inhuman mechanism.
So empathy for the long suffering inhabitants of corporate cubicles, whose personalities are at risk of being erased, does come to the surface after all. The laughter largely dissolves the cynicism. It is a commonplace in the organizational world that people function as replaceable cogs in a well-oiled machine. Therefore, the cartoon is an example of what not to do. Cynicism and shame drive out empathy; and, more importantly, driving out cynicism and shame create a space into which empathy stands a chance and can expand spontaneously.
How then does one drive out cynicism, shame, denial, and so on? The short answer is by calling it out, acknowledging it, interpreting it, and offering an alternative point of view. Not “alternative facts,” which have come to mean “spin” and “deception”; but an alternative perspective. It is now cynicism versus empathy in the organization.
For example: “Given the challenges we are facing, it is easy to become cynical. However, I have an alternative point of view. If we adhere to our commitments, then the way forward is clear. Not easy, but clear. We have to … remember who we authentically are, serve the customer, be inclusive, expand the community, be guided by our empathy (and so on). We have to live up to our commitment that everyone who comes in contact with the organization, even if we cannot completely solve their problem, is left whole and complete, treated with dignity and respect (and empathy).”
In the face of pervasive cynicism, it takes courage for a person to responds empathically. Such a person may be perceived as a threat to the prevailing, default attitude of “I won’t call you on your lack of authenticity if you don’t call me on mine.” Such a committed person is at risk in standing out from the crowd; but such a person just might provide the leadership, gather the power to make a difference, get the job done with grace and ease under pressure—and get a promotion.
One does not even have to stop being cynical, since it is so pervasive, but one has to adhere to one’s commitment to making a contribution, work to make a positive difference, and deliver value on one’s agreements.
Cynicism is shown up for what it is: taking the easy way out. The practice of empathy is hard work.
It is not only the executive suite, but also the front and back office and every part of the supply chain in between that are staffed by harried people pushed down into survival mode by a cruel gig economy where empathy is not a priority. Of course, empathy gets paid lip service. Please pardon the double negative—one dare not not pay empathy lip service.
However, all-too-often, empathy is too messy. It is too complex. We are not even sure what empathy would mean in an organizational context. We need results now. Suck it up. Get over it. Conform! Nor is there anything wrong with conforming as such. Submit your expense report on time. Even the customer wants to conform, if only he could get the product to function as designed. It is just that empathy is too time consuming, which means—it is too costly.
Yet never was empathy more important than when it seems there is no time for it. Positively expressed, as with most forms of resistance, the method of overcoming it is to call it out and interpret it. Once visible and explicit, it is less formidable.
The empathy of cross-functional teams, managing by walking around, making a contribution, building the bigger team, being inclusive of all the stake-holders, communicating goals and connecting the dots between individual accomplishments and the objectives of the entire organization—these create a clearing in which empathy shows up and makes a profound contribution to the success of the organization.
In addition, one’s employer is not one’s parent. Remember the sign in the common kitchen that says “Your mother does not work here—clean up your dirty dishes!”? Of course your mom told you that, too, and she did “work here” at home, and it still hasn’t snuck in.
Notwithstanding the rich comic possibilities, one’s employer and its leaders do indeed “work here.” Leaders provide powerful examples to whom we look for inspiration. This must give one pause about the state of leadership today. Just as children have to get empathy from their parents before they can give it to others, employees have to see and experience examples of empathy from their leaders to be effective in their own roles as individual contributors. The idea is not to be paternalistic, but to lead by example, the example of empathy.
The difference between banging on a stone and building a cathedral
Executives of all kinds have varying degrees of empathy and different attitudes towards it. It may sound like yet another burden that the CEO now also has to take the role of “Chief Empathy Officer.” This comes up for detailed discussion below in the chapter on the empathy application to “Business and empathy, capitalist tool.”
Meanwhile, when I am bold and ask executives what is the budget in the organization for empathy training and empathy consulting, they usually look at me with a blank stare or just say “zero.” However, when I ask what is the budget to reduce conflict, enhance teamwork, innovate and improve productivity, inspire participation, cause the staff to take ownership of the mission and honor their agreements, then the leaderships sees possibility where none had previously been present and makes it a priority to obtain a budget.
Simply stated, empathy training consists in surfacing the resistances to empathy, the pervasive fear and cynicism (and so on) in the organization that lurks just beneath the surface; interpreting the resistance, and driving it out: “It is perfectly understandable that you would be cynical, given what you have been through, but that is not who you (we) authentically are. Rather we are the possibility of [health, transportation, nutrition, education, retirement, housing, recreation, and so on (according to the mission of the organization)].”
What would it take to design agreements that overcome resistance and commit to aligning organizational and individual goals and then taking action to implement the agreements on an ongoing schedule? The empathy training consists in engaging in a sustained dialogue for possibility around agreements that work for everyone in delivering value.
In particular, overcoming resistance to empathy, expanding empathy, is on the critical path to eliminating or at least reducing organizational conflicts and dysfunctional behaviors. When staff, executives, stake-holders, and so on, expand their empathy for one another and for customers, they are able to deescalate confrontations and negativity; they avoid provocative and devaluing language; and they are able to head off dignity violations, all of which reduce the conflicts that literally suck the life out of organizations.
When employees appreciate the possibilities of empathy, they even try to replace office politics with professional behavior. Staff get more done because they can concentrate on doing their jobs, working smarter, and serving customers and coworkers rather than struggling with departmental politics.
In addition, expanding empathy—overcoming resistance to empathy—is on the critical path to building teams. Empathy is the foundation of community, and the team is nothing if not a community. In empathy, people practice giving acknowledgment and recognition for their contribution to the success of the team and the organization. Being inclusive does not always come naturally or easily to us humans, territorial creatures that we are. We oscillate between closeness and distance like a pendulum.
However, no organization can succeed without including every contributor and turning him or her loose to do the job at hand. Even in hierarchical organizations, where departmental boundaries are rigid, empathy works to demonstrate that good fences makes good neighbors but that gates are needed in the fences through which empathy can be practiced.
Expanding empathy is also on the critical path to innovation and enhancing productivity, because people feel gotten for whom they are as a possibility and as a contribution. They stop withholding and working in quasi-competitive isolation. When they get in touch with one another as possibilities, the business results take off.
Successful leaders know the importance of drawing on the talents of every contributor. When employees get a sense of how their role and contribution fits into the whole, they work to deliver on their commitments.
That is the key to improved productivity. People are generous in sharing their ideas for process and product improvement, because they feel confident their contribution makes a difference and is recognized. For example, two workers are going through the same motions, making the same gestures. An empathic milieu makes the difference between the one, who is banging with a hammer and chisel on a chunk of stone, and the other, who is building a cathedral. The worker’s gestures are exactly the same. The one is sentenced to hard labor; the other participates in greatness.
[i] Jodi Halpern. (2001). From Detached Concern to Empathy: Humanizing Medical Practice. Oxford: Oxford University Press.
[ii] Scott Adams. (1996). The Dilbert Principle. New York: Harper Business.
The Natural Empath Meets the Good Samaritan
A person can regulate his or her empathy up or down by crossing the street. The empathy lesson is that if you can cross the street to avoid the beggar, regulating your empathy down, then you can cross the street (as well as use other methods) to expand your empathy, regulating it upward. So don’t tell me that empathy cannot be dialed up or dialed down with practice. That’s the point: practice.
Crossing the street is what happened in another story with which many readers are already familiar. The story of the Good Samaritan, one of the parables of Jesus of Nazareth, tells of two people who crossed the street, and one who did not. In the story, a traveler was waylaid by robbers. He is left for dead by the side of the road. The first two persons—the Levite and the priest experienced empathic distress, and, crossed the street, passing by the victim.
The Samaritan, however, was not overwhelmed by the victim’s suffering. The Samaritan perceived the suffering; he had a vicarious experience of the suffering that did not over-stimulate him with suffering and cause empathic distress. The Samaritan saw a fellow human being; recognized the suffering humanity; and he decided to get involved.
Multiple empathy lessons are available here. First, to regulate one’s empathy, cross the street. This is an edgy and confrontational way of putting it, but it is literally accurate. Cross the street away from the neighbor to “down regulate” your empathy, and experience less empathic distress; and cross the street towards your neighbor to expand your empathy in the direction of creating an inclusive community of persons, who recognize the value of cooperation.
The empathy lesson is that the vicarious experience does not have to be overwhelming. Rather, with practice, one is able to shift one’s focus from suffering to neighborliness; one is able to shift one’s attention from suffering to making a difference and enhanced self-esteem, expanding community and shared humanity.
Crossing the street is not the only way to reduce one’s chance of empathic distress or responding empathically. One may imaginatively changes places with the survivor and reflect that one would want the other’s help if one were in a similar predicament. One may spontaneously and without thinking act impulsively to be helpful, because one’s upbringing has made such responsiveness a habitual practice. (I believe this was the case with the Samaritan.) One may reflect, “I am safe and the survivor is no danger to me and it is my turn to help out.”
Or, on the contrary, one may make a devaluing judgment such as “The guy deserved what he got.” Such a judgment would be inaccurate—and in this case it would literally add insult to injury—but such thoughts do occur among by-standers. The passers-by may have just been hard-hearted. One person’s empathy is another’s antipathy. The language speaks volumes.
The empathy lesson consists in distinguishing such a devaluing thought; acknowledging that thinking is profoundly different than acting and should not be confused with it. The empathy lessons is to take action coming from one’s authentic commitments to building community through empathy, not devaluing thoughts.
This story is an empathy lesson that also instructs us in the difference between empathy and compassion. The Samaritan’s empathy told him what the other person was experiencing; his compassion (and ethics) told him what to do about it.
This bears repeating: empathy tells one what the other person is experiencing; compassion (and ethics) tell one what to do about it.
We are usually taught to devalue the behavior of the Levite and the priest; and surely they do not win a prize. Yet in an alternative point of view, they were all-too-human. Seeing all that suffering embodied in the survivor, they just couldn’t take it. They succumbed to empathic distress.
They experienced a breakdown of their empathic receptivity, and were overwhelmed in a kind of instant empathy fatigue (not compassion fatigue).
In an alternative reading of the parable, the would-be rescuers dial down the granularity of their empathic receptivity, so as not to be too sensitive to the suffering, even as they get a sample of the suffering, which is needed to inform their humanity.
The Good Samaritan, who is a seemingly infinite source of insight, is called to his empathic neighborliness by the distress of the injured traveller. The traveller who had fallen among thieves and was beaten near to death creates the possibility of empathic community by his loss of human well-being. He has been reduced to a lump of suffering, broken, physical pain.
The Samaritan rescues the traveller; the traveller humanizes the Samaritan, calling him not just to the role of an altruist doing a good deed (though that occurs too), but to his possibility as a human being in relation to another fragile, suffering, dependent human being.
The stricken traveller, by his very being, gives the Samaritan his own humanness. This occurs precisely in making the Samaritan a neighbor in answering the question, “Who is one’s neighbor?” Such was the trick question that the Pharisees posed to Jesus, to which this parable is the response.
The Samaritan gives humanness to the distressed traveller in an intervention that defines them as part of the same community of fellow travellers—neighbors—on the road of life.
In an alternative retelling of the story suppose that the Levite and the priest were “natural empaths,” biologically predisposed to be sensitive to the pain and suffering of other people. They were endowed with a certain “delicacy of empathy,” and they feel the suffering of the world deeply. Perhaps too deeply. Some people report: “I am a natural empath—and I suffer because I feel the pain of others too acutely. I started out being empathic—but people took advantage of me—and even when they didn’t, I was just too empathic; I got overwhelmed with sensation and sucked dry—the result was burnout, compassion fatigue. Nice guys finish last—so do empathic ones.”
Thus, the lament of the natural empath.
Empathy becomes a burden, because the world is filled with so much suffering. Yet if the person uses avoidance to “down regulate” their empathy, the person feels guilty because the individual believes that what she is doing is unkind, thoughtless, lacking in fellow feeling, and—unempathic.
So the natural empath falls into a double bind, and her suffering seems inevitable. She is over-whelmed by too much openness to the suffering of the other person or over-whelmed by guilt at not living up to her own standards of fellow-feeling and ethics.
These statements imply that empathy cannot be regulated through training, albeit a training that goes in the opposite direction (from too much empathy in the moment to less empathy) than that required by the majority of people, who are out of touch with their feelings and need to “up regulate” their empathy. The empathy lesson for the natural empath is to be more flexible about her ethical standards, while attempting to tune down her empathic distress.
Some people are skeptical that “natural empaths” are all that they say they are. Natural empaths in their natural state assert that they feel overwhelmed and distressed by other people’s thoughts and feelings. I see no reason to doubt such statements. However, to some critics, a redescription of the natural empath asserts that the latter are “irritable” and “hypersensitive.”
Empathy is recognizing and understanding the other’s perspective and then communicating that understanding to the other person. Someone who is unwittingly, even helplessly, swept along by the other’s feelings is not really being empathic. Over-identification, not empathy?[i]
The way out of this apparent impasse is to consider that the natural empath does indeed get empathic receptivity right in empathic openness to the other’s distress, but then the person’s empathy misfires.
Whether the misfiring is over-identification, resulting in empathic distress, depends on the description and redescription. Standing on the sidelines and saying “Try harder!” is easy to do. Where is the training the person needs when they need it?
The recommendation regarding training? Most people need to expand their empathy; some people—natural empaths—need to contract (or inhibit) their empathy. Empathy regulation—learning to expand and contract empathy—is the imperative in either case.
Instead of complaining about being an overly sensitive natural empath (however accurate that may be) do the work of practicing empathy by “down regulating” one’s empathy in a given situation, transforming empathic distress into a vicarious experience. Instead of complaining about not being pre-disposed to empathy, get up and do the work of practicing empathy, which for most persons means “up regulating,” expanding their empathy.
[i] Lou Agosta, (2018). Empathy Lessons. Chicago: Two Pairs Press: Order empathy books click here: https://rb.gy/avwkb7
Review: Galileo’s Middle Finger: Speaking Truth to [Transgender] Power – and Power Talks Back
https://open.spotify.com/embed/episode/7bmxO2s0F4LwmQoDbnwy7l?utm_source=generator
A scientist has not been burned at the stake in over 350 years – and even then it was Giordano Bruno, not Galileo. Find out how Professor Alice Dreger (PhD) become an advocate for survivors of intersex sexual reassignment surgery and she becomes a strong candidate to be burned in effigy by those for whom she was advocating.
This is a reposting of a book review from 2015, now included as a podcast (originally recorded on April 29, 2015 with Alice Dreger, PhD, Professor of Medical Humanities, Northwestern Feinberg School of Medicine).
With transgender dynamics, identity, politics, and everything exploding in the headlines, the need for empathy around sexual identity and related issues is even more urgent and timely today than when originally broadcast.
Join me for a conversation with Alice Dreger about the conflict between scientific evidence and some interpretations of social justice and “empathy” (in quotation marks). Dreger starts out as a graduate student exploring the condition [previously] known as “hermaphroditism,” people born with sex organs that are ambiguous as to male or female, now called “intersex.”
In reading the text books studied by her medical student husband, she discovers the interventions performed to “normalize” people sexually into the two canonical categories of male or female. The parents usually follow the recommendations of the physician-surgeon who are articulating a supposed community standard that one’s genitals should unambiguously be either male or female. Dreger discovers that many of the people whose genitals were surgically transformed were subsequently lied to about their natal [birth] sex by well-intentioned doctors and well-intentioned parents following the well-intentioned doctor’s guidance. Thus, the road to hell. Find out what happens when Dreger’s research surfaces evidence that does not align perfectly with the interpretation of a social justice agenda.
This is a powerful and disturbing work. Dreger delivers a compelling narrative. A penis smaller than a person’s adult thumb or clitorises larger than one little finger, according to (some) conventional wisdom, have got to go. I am not making this up. The standard procedure was to surgically “delete” the offending member and surgically construct [some version of] the female genitals. This will, of course, resonate with Freudians everywhere as something motivated at the deepest levels of the unconscious. Not so Freudian is the proposition that if sex assignment from male to female and the raising of the infant as one rather than the other sex is the consequence, so be it. (Dreger is not interested in Freud in this text – that is my hobby.)
Dreger marshals evidence that people whose genitals are not surgically transformed as infants – but who have non-standard but otherwise healthy functioning genitals – are not worse off than those whose genitals were modified, and in many cases flourish. In at least one case, where the boy could not urinate standing up – and write his name in the snow with the stream of urine – due to the opening to the urethra being beneath the pen, the result of the surgery often produces a “cripple”. Yet the surgery continues to be performed. In other instance, the major concern expressed by the medical text books was that the child would become lesbian or gay. Ouch.
Dreger “goes to bat” for these intersex individuals, recovering their narratives out of medical records and journals where they had been documented as cases. She advocates for them. She lobbies, blogs, publishes in the popular press. Then the unintended consequences hit. Some of those for whom she is advocating don’t like some of the evidence Dreger publishes. It is not sufficiently “on point” about transgender issues being exclusively a function of a man’s brain born in a woman’s body or vice versa. The idea that a man could love himself as a woman and so want to become a woman does not compute.
As one might expect, research produces subtle nuances that require more than a sound byte or even a blog post. Suddenly Dreger finds herself the target of anger from the advocates for whom she was lobbying. It is not pretty. It gets ugly. Think self-righteous indignation as an expression of narcissistic rage and having one’s deeply felt values questioned by the evidence. There is no easy way to say it: some advocates of social justice seem to feel that the end justifies the means. The “means” include rampant forms of bullying and in-your-face confrontation, including charges of dubious ethical violations, invalid research, fictional claims about the researcher’s relations with his or her children and family, and the posting of toxic gossip on the Internet. The cause may be righteous, but the behavior is wicked and mischievous if not heinous.
Dreger survives and is vindicated. But then she begins to wonder if her experience of the collision of scientific evidence with advocacy and versions of its conventional wisdom was exceptional. Like most survivors she asks: “Is it just me?” It is not. It reminds her of the conflict between Galileo and the sedimented beliefs of the Church of his time.
A point that underlies Dreger’s work and may usefully be made more explicit: The facts of empirical science are fragile. Not only can they be shouted down by bullies, purged by tyrants such the Italian Inquisition of the 16th century, or simply ignored by the average person, the facts can also be set upon by academic, university, or institutional agendas more dedicated to building a corporate brand – and being financially well funded – than attaining an evidence-based version of the truth.
(An early version of this thesis, perhaps unknown to Dreger, is Hannah Arendt’s work on Truth and Politics. Not a historian of medicine but of political theory, Arendt makes the powerful point that if all versions of Euclid’s Geometry had been destroyed, mathematicians would still be able to recreate formal geometry out of the a priori forms of space and time; but if Stalin had really succeeded in purging all examples that such a person as Leon Trotsky had existed, then we really never would have heard of such an individual’s factual existence. Facts are fragile. )
A case in point. It is conventional wisdom since Susan Brownmiller’s Against Our Wills (1975), that rape is primarily an act of power by the perpetrator (usually a man), not one of sex. While not primarily a scientific treatise, it becomes the basis for research that gathers sufficient evidence and the thesis “power not sex” becomes “conventional wisdom.”
Enter a young (male) scholar who has a strong hunch he can prove an exception to the rule. No, sometimes rape is motivated by sex. Sometimes a guy, who has no prospect that the intended woman would have sex with him (but who he desires sexually) decides to use force. This naïve academic sees a dissertation topic that is a cut above the usual scholarly drivel. A dissertation is delivered to that effect. Not only does all hell break loose – he is silenced by angry activists – but it gets worse. The phone rings. It is a prosecuting attorney needing help with a case.
The District Attorney is bringing charges against a perpetrator, an alleged rapist standing trial for his crime. The defense is arguing effectively that science has shown that rape is about power, not sex. The perpetrator could not possibly have been motivated to the crime by sex. Science says so. Wait a minute. Rape is never about sex? It is now a defense against rape that there was no other motive than sex?
Since 1975 we have seen date rape and the use of incapacitating “date rape drugs” such as anesthetics facilitate the violation. Surely advocates and scientists can encompass the possibility that sometimes rape is about power, sometimes it is about sex, and sometimes, it is both (p. 125). Don’t be too sure. There is a deep lesson about human nature here. Constant dialogue is needed to keep people in rational communication without distortion and manipulation. The desire to be righteous and justified is pervasive and extends across all political spectrums. The ability to listen has rarely been in such short supply.
Another case. Napoleon Chagnon writes an innovative and disruptive work of anthropology (Yanomamö: The Fierce People). He argues that Margaret Mead’s vision of a peaceful coming of age in Samoa in a sexually liberated version of a hippie-like commune may not be the only paradigm of the life of native indigenous peoples. (Mead herself was subjected to a debunking, the factual basis of which turned out to be, shall we say, less than rock solid.) The Yanomamö in South America are more like warring bands of Hobbes’ “war of all against all” or the tribes of the Peloponnesian peninsula, with Achilles throwing a narcissistic fit – “I stole her fair and square” – because Agamemnon took his plundered woman.
Chagnon is a virtual Dreyfus Affair in the American Association of Anthropologists. Alfred Dreyfus (you may recall) was stripped of his epaulets, his campaign badges ripped off his chest, and he was banished to Devil’s Island (my metaphor, not Dreger’s). Years later, Chagnon is vindicated (as was Dreyfus) and “rehabilitated.” But only after years of upset, suffering, and the monumental expense of mounting a defense against false accusations as recounted in his My Life Among Two Dangerous Tribes – the Yanomamö and the Anthropologists. The bottom line? According to Dreger, in addition to the political infighting, wicked and mischievous gossip, and an alleged series of narcissistic injuries unintentionally committed by Chagnon against colleagues, it was politically inexpedient to represent indigenous peoples as warlike.
Dreger documents in detail the appalling political intrigues, plots misfired and rebounding onto the heads of the perpetrators, and the narrow mindedness of academics who ought to have adhered to scientific standards rather than tit-for-tat gamesmanship. Dreger’s work is definitely a page turner, reading like a spy novel or an account out of Kafka’s The Trial. Speaking personally, it made me paranoid at points. I felt discouraged at the alternating narcissistic rage and petty retaliation enacted for real or imagined slights to which both scientists and advocates for social justice seem all-too-prone.
The drama goes on. It escalates. Maria New, MD, is a celebrity woman’s doctor of long service and, at least initially, significant distinction. Dr New advocates that early stage pregnant women take dexamethasone (off-label, though FDA approved to prevent miscarriage) when the parental profile shows a one in eight chance that the female fetus may have congenital adrenal hyperplasic (CAH)). Basically CAH means that the baby might be a “boyish girl” if left untreated. Heavens to mergatroid – a lesbian? But since there were never any controlled studies of the consequences of taking dexamethasone (dex), it is not clear if the cognitive impairment, the deformed genitals, other anomalies, were due to the action of the drug or whether the drug was simply ineffective for its off-label use.
Dreger believes she has an “open and shut” case of an ethical violation that research subjects were not informed that they were participating in what amounts to a experiment, a far cry from a “safe and effective” treatment. The FDA oversight representative embedded in the research teams raises a number of red flags. Her career is ended on a pretext, and Dr New transitions to a different university without so much as a warning in any file.
One thing is for sure. Taking the case to the FDA and the Office of Human Research Protection (OHRP) reveals a level of indifference, human clumsiness, and subtle, unexamined conflicts of interest and self-dealing that again approach’s Kafka’s The Trial. Appalling. By the way, if ones want to receive this treatment during early stage pregnancy with the hope of dialing down the masculinization of the fetus, it is still legally available from Dr New and her associates, though Dreger has made it her project to dominate the Google listings with warnings about the risks of the treatment.
Dreger’s point is that the use of dex to influence the process of masculization of the fetus is experimental as used off label (the “on label” use is not to treat CAH, but to prevent miscarriage, for which it seems to be effective). The women to whom it was given to treat CAH were never told and never signed an informed consent form to participate in what was basically an experimental use of the drug. “Safe and effective” remains unproven for CAH, and evidence to the contrary is emerging. However, what really put the kabash on the treatment with dex is that it has been branded an anti-Lesbian drug. More good news. It is not as bad as thalidomide; but possibly another DES fiasco in the making.
In conclusion, Dreger offers reflections inspired by the Founding Fathers of the early days of the United States and such politician-statesmen as Benjamin Franklin. No stranger to risk, Franklin was both flying a kite in a thunderstorm and building a structure of government capable of correcting its own errors (not on the same day). Thanks to such men, we are all better off than Galileo when speaking truth to power. Free scientific inquiry needs a free social and fair political space to flourish. Justice requires access to accurate facts and a way of testing evidence that distinguishes fact from fiction The truth is vulnerable to the influences and distortions of the social organization of power.
Granted that a scientist has not been burned at the stake for over 500 years, that is no reason for complacency. I could not help but think that Professor Dreger was well on the way to being a candidate, though admittedly the burning was “in effigy.” Bad enough! There have been many ruined careers and damaged lives due to bullying and political abuses. Dreger bemoans the “push down” of the press and investigative journalism – in short, the decline of the press beneath the pressures of a publishing market in distress, the Google-ad-industrial-complex, and on the Internet no one knows you are a dog. While the Internet is a multi-edged sword and sends fear into the hearts of tyrants everywhere, it is easy to abuse. It is a dubious format for rational discourse and evidence-based anything. That should not stop one from posting her or his peer-reviewed research (this is not an example of that) but it means one must also mount the soap-box on a regular basis and speak truth to power.
Alice Dreger. (2015). Galileo’s Middle Finger: Heretics, Activists, and the Search for Justice in Science. New York: Penguin.
UPDATE (May 27, 2026): A way to challenge the groupthink of scholarly journals by Kevin McCaffree and Colin Wright: https://www.wsj.com/opinion/a-way-to-challenge-the-groupthink-of-scholarly-journals-8e59b215?st=uFFPy3&reflink=desktopwebshare_permalink
(c) Lou Agosta, PhD and the Chicago Empathy Project
Radio Empathy is now on the air as a podcast: New episode: A rigorous and critical empathy: Perform a readiness assessment
Empathy is never needed more than when it seems there is no time for it. Empathy is never needed more than when it seems the budget does not allow for it. Empathy is never needed more than when the cynicism and resignation about life, whether in the family or the corporate jungle, are so thick you can’t catch your breath.
Being ready for empathy is like being ready to be born. No one is ready to be born. You just get born. Ready or not, the individual is thrown into the world. No one asked you if you wanted a life. You just got one.
Empathy enables you to have a human existence filled with satisfying, engaging, dynamic, fulfilling relationships instead of living in an empty, depopulated emotional desert.
There is enough empathy to go around. The key to the empathy readiness assessment is realizing enough empathy is available for everyone. Empathy is not a zero sum game. There do not have to be losers versus winners. If you can get your head around the idea that there is enough empathy available in the world—crazy as that idea may seem at first—then you are ready to engage with expanding empathy in your life and the community.

Seems impossible? Let us take a step back. You know how we can feed everyone on the planet, so that there should be no need for people to get sick and die of starvation? Thanks to the “Green Revolution,” high tech seeds, and the economies of scale of agri-business, enough food exists to feed everyone. Yet people are starving. People are starving in the Middle East, Africa, and in parts of the USA. People are starving because of politics in the pejorative sense, breakdowns in social justice, violence, aggression, bullying, cynicism, bias, prejudice, fragmentation of communities, and human badness. There is enough food to feed everyone, but it is badly distributed.
Likewise, with empathy. Enough empathy is available to go around; but it is not evenly distributed. People are living and working in empathy deserts.
Organizational politics in the pejorative sense of the words, attempts to control and dominate, egocentrism and narcissism, out-and-out aggression and greed, stress and burnout, all result in empathy deserts. Empathy gets hoarded, creating empathy deserts locally, even amid an abundant ability to practice empathy.
Create a clearing for success in working on expanding your empathy, contributing to growing empathy in yourself, other individuals, and the community. Perform a readiness assessment for empathy training
Therefore, this guide to bringing forth a rigorous and critical empathy training does not call for “more” empathy, but rather for “expanded” empathy. The difference is subtle. Commenting “We need more empathy here!” implies the individual is unempathic—are you saying I lack empathy!?—and that is an insult, a dignity violation, a narcissistic injury, creating even more conflict and shrinking empathy.
The way we put our words together makes a profound difference. Experience indicates the call for “more empathy” results in a further breakdown of empathy. In contrast, calling for “expanded empathy” makes a difference in getting unstuck from difficult, sticky situations, reestablishing relatedness, de-escalating conflict, interrupting anger or soothing rage, shifting out of upset, and overcoming the challenges of relating in a world that can from time-to-time be decidedly unempathic.
In extreme cases, a person may in fact lack empathy in a medical or legal sense—the serial killer, the psychopath, and persons suffering from mental illnesses, or, more sympathetically, one of the disorders of empathy such as an autism spectrum disorder. However, such persons are exceptions or in an exceptional situation.
In most cases, individuals have a significant empathic ability with which the individual is out of touch. The person lacks self-knowledge, has a blind spot, and does not know himself to be empathic. The person’s empathy is implicit and is waiting to be expanded. Therefore, a rigorous and critical guide calls out for expanded empathy—to leverage the kernel of empathy that already exists in the person’s humanity and develop it, if not into a mountain, at least into a heaping hill of empathy.
One reason that empathy training programs have not worked or have produced disappointing results is that they train the participants in compassion, being nice, conflict resolution, baby and child care, and a number of worthy and admirable skills. This is all well and good, and the use of compassionate methods is making the world a better place in all these situations. So keep it up. There is nothing wrong with reducing conflict, being nice, agreeable, and so on: do not be “unnice.” But paradoxically something is missing—practicing a rigorous and critical empathy.
Now I do not wish to give anyone a bad name, especially anyone who is committed to empathy, compassion, conflict resolution, or making a difference in overcoming human pain and suffering. On the contrary, I acknowledge and honor one and all. The battle against suffering is joined; we are all on the same side; and we want to deploy our resources wisely.
As soon as one announces a commitment (for example): “I am going to expand empathy in my life,” then all the reasons that it is utterly impossible to do so show up. “What are you thinkin’ fella?” Not enough time. Not enough money. Resistance to empathy does not mean that one fails the readiness assessment to expand one’s empathy. It means that one is a human being.
People have blind spots about empathy. People have blind spots, period. Part of the readiness assessment? Those who take the implicit bias test discover they have biases—often several (see Teaching Tolerance 2020). When it comes to doing the work required actually to listen and respond empathically to others, people make exceptions for themselves—and their biases and inauthenticities. No exceptions!
The one question readiness assessment for empathy is: “Am I ready to do what it takes to clean up my inauthenticities in my practice of empathy?” (Key term: clean up.) Even if you are not completely sure what this means, being willing to agree to the statement is enough to get started.
When it comes to a readiness assessment, the “willingness” is easy. Speaking personally, even lazy people can get their heads around willingness; and once a person puts his foot out onto the slippery slope of willingness, well, it is downhill all way. Sliding downhill may have its occasional bumps, and you have to apply the brake at times; but it is a lot easier than climbing up the hill.
Look it, dude. I would be kidding you if I said no effort is required. Effort is required to expand your empathy. It is going to take something—and, at times, something extra by way of effort. Mostly it requires taking an honest look at oneself. That is not trivial. It may be confronting. But if you are getting vicariously traumatized trying to be empathic, then you are doing it wrong. Throttle back. Take a break.
Being willing to clean up one’s authenticities is precisely the empathy lesson. The “gotcha” is that the inauthenticities in one’s life are not limited just to empathy. However, empathy leads the way. The readiness for a rigorous and critical empathy requires, well, rigor and a willingness to be self-critical. The readiness for empathy requires doing the work required to create a clearing for empathic success, a clearing of integrity and authenticity.
(c) Lou Agosta, PhD and the Chicago Empathy Project
Review: The Empathy Diaries: A Memoir by Sherry Turkle
The short review: the title, The Empathy Diaries: A Memoir (Sherry Turkle New York: Penguin Press, 2021, 357 pp.) reveals that empathy lives, comes forth, in empathy’s breakdowns and failings. Empathy often emerges in clarifying a lack of empathy. This work might have been entitled, less elegantly, “The Lack of Empathy Diaries.” I found the book to be compellingly written, even a page-turner at times, highly recommended. But, caution, this is not a “soft ball” review.”
Do not misunderstand me. Sherry Turkle’s mom (Harriet), Aunt Mildred, grand parents, and the extended Jewish family, growing up between Brooklyn and Rockaway, NY, were empathic enough. They were generous in their genteel poverty. They gloried in flirting with communism and emphasizing, in the USA, it was a federal offense to open anyone else’s mail. Privacy is one of the foundations of empathy – and democracy. Sherry’s folks talked back to the black and white TV, and struggled economically in the lower middle class, getting dressed up for Sabbath on High Holidays and shaking hands with the neighbors on the steps of the synagogue as if they could afford the seats, which they could not, then discretely disappearing.
As Tolstoy famously noted, all happy families are alike. What Tolstoy did not note was that many happy families are also unhappy ones. Figure that one out! Sherry’s answer to Tolstoy is her memoir.
Families have secrets, and one was imposed on the young Sherry. Her mother married Charles Zimmerman, which was her last name as he was the biological father. Within a noticeably short time, mom discovered a compelling reason to divorce Charles. The revelation of his “experiments” on the young Sherry form a suspenseful core to the narrative, about which more shortly.
Mom gets rid of Charles and within about another year marries Milton Turkle, which becomes Sherry’s name at home and the name preferred by her Mom for purposes of forming a family. There’s some weirdness with this guy, too, which eventually emerges; but he does have a penis and a younger brother and sister show up apace.
In our own age of blended families, trial marriages, and common divorce, many readers are, like, “What’s the issue?” The issues is that in the late 1950s and early 1960s, even as the sexual revolution and first feminist wave were exploding on the scene, in many communities, divorce was stigmatizing. Key term: stigma. Don’t talk about it. It is your dark secret.
The rule for Sherry of tender age was “you are really a Turkle at home and at the local deli; but at school you are a Zimmerman.” Once again, while that may be a concern, what’s the big deal? The issue is: Sherry, you are not allowed to talk about it. It is a secret. Magical thinking thrives. To young Sherry’s mind, she is wondering if it comes out will she perhaps no longer be a part of the family – abandoned, expelled, exiled. Even the siblings do not find out about the “name of the father” (a Lacanian allusion) until adulthood. A well kept secret indeed. Your books from school, Sherry, which have “Zimmerman” written in them, must be kept in a special locked cupboard.
How shall I put it delicately? Such grown up values and personal politics – and craziness – could get a kid of tender age off her game. This could get one confused or even a tad neurotic oneself. The details of how all these dynamics get worked out make for a page turner.
Fast forward. Sherry finds a way to escape from this craziness through education. Sherry is smart. Very smart. Her traditionally inclined elders tell her, “Read!” They won’t let her do chores. “Read!” Reading is a practice that expands one’s empathy. This being the early 1960s, her folks make sure she does not learn how to type. No way she is going to the typing pool to become some professors typist. She is going to be the professor! This, too, is the kind of empathy on the part of her family unit, who recognized who she was, even amidst the impingements and perpetrations.
Speaking personally, I felt a special kinship with this young person, because something similar happened to me. I escaped from a difficult family situation through education, though all the details are different – and I had to do a bunch of chores, too!
The path is winding and labyrinthine; but that’s what happened. Sherry gets a good scholarship to Radcliffe (women were not yet allowed to register at Harvard). She meets and is mentored by celebrity sociologist David Reisman (The Lonely Crowd) and other less famous but equally inspiring teachers.
She gets a grant to undertake a social psychological inquiry into the community of French psychoanalysis, an ethnographic study not of an indigenous tribe in Borneo but a kind of tribe nonetheless in the vicinity of Paris, France.
The notorious “bad boy” Jacque Lacan is disrupting all matters psychoanalytic. His innovations consist in fomenting rebellion in psychoanalytic thinking and in the community. “The name of the father” (Lacan’s idea about Oedipus) resonates with Turkle personally.
Lacan speaks truth to [psychoanalytic] power, resulting in one schism after another in the structure of psychoanalytic institutes and societies. Turkle intellectually dances around the hypocrisy, hidden in plain view, but ultimately calls it out: challenging authority is encouraged as long as the challenge is not directed at the charismatic leader, Lacan, himself. This is happening shortly after the students and workers form alliance in Paris May 1968, disrupting the values and authority of traditional bourgeois society. A Rashomon story indeed. Turkle’s working knowledge of the French language makes rapid advances.
Turkle, whose own psychoanalysis is performed by more conventional American analysts in the vicinity of Boston (see the book for further details), is befriended by Lacan. This is because Lacan wants her to write nice things about him. He is didactic, non enigmatic amid his enigmatic ciphers. Jaques is nice to her. I am telling you – you can’t make this stuff up. Turkle is perhaps the only – how shall I put it delicately – attractive woman academic that he does not try to seduce. Lacan “gets it” – even amid his own flawed empathy – you don’t mess with this one. Yet Lacan’s trip to Boston – Harvard and MIT – ends in disaster. This has nothing – okay, little – to do with Turkle – though her colleague are snarky. The reason? Simple: Lacan can’t stop being Lacan.
Turkle’s long and deep history of having to live with the “Zimmerman / Turkle” name of the father lie, hidden in plain view, leaves Turkle vulnerable in matters of the heart. She meets and is swept off her feet by Seymour Papert, named-chair professor at MIT, an innovator in computing technology and child psychology, the collaborator with Marvin Minsky, and author of Mindstorms: Children, Computers and Powerful Ideas.
Seymour ends up being easy to dislike in spite of his authentic personal charm, near manic enthusiasm, interestingness, and cognitive pyrotechnics. Warning signs include the surprising ways Sherry have to find out about his grown up daughter and second wife, who is actually the first one. Sherry is vulnerable to being lied to. The final straw is Seymour’s cohabitating with a woman in Paris over the summer, by this time married to Sherry. Game over; likewise, the marriage. To everyones credit, they remain friends.
Sherry’s academic career features penetrating and innovative inquiries into how smart phone, networked devices, and screens – especially screens – affect our attention and conversations. The research methods are powerful: she talks to people, notes what they say, and tries to understand their relationships with one another and with evocative objects, the latter not exactly Winnicott’s transitional objects, but perhaps close enough for purposes of a short review.
The reader can imagine her technology mesmerized colleagues at MIT not being thrilled by her critique of the less than humanizing aspects of all these interruptions, eruptions, and corruptions of and to our attention and ability to be fully present with other human beings.
After a struggle, finding a diplomatic way of speaking truth to power, Turkle gets her tenured professorship, reversing an initial denial (something that rarely happens). The denouement is complete. The finalè is at hand.
Sherry hires a private detective and reestablishes contact with her biological father, Charles. His “experiments” on Sherry that caused her mother to end the marriage, indeed flee from it, turn out to be an extreme version of the “blank face” attachment exercises pioneered by Mary Main, Mary Ainsworth and colleagues, based on John Bowlby’s attachment theory. The key word here is: extreme. I speculate that Charles was apparently also influenced by Harry Harlow’s “love studies” with rhesus monkeys, subjecting them to extreme maternal deprivation (and this is not in Turkle). It didn’t do the monkeys a lot of good, taking down their capacity to love, attachment, much less the ability to be empathic (a term noticeably missing from Harlow), leaving them, austic like emotional hulks, preferring clinging to surrogate cloth mothers to food. Not pretty. In short, Sherry’s mother comes home unexpectedly to find Sherry (of tender age) crying her eyes out in distress, all alone, with Charles in the next room. Charles offers mom co-authorship of the article to be published, confirming that he really doesn’t get it. Game over; likewise, the marriage.
On a personal note, I was engaged by Turkle’s account of her time at the University of Chicago. Scene change. She is sitting there in lecture room Social Science 122, which I myself frequented. Bruno Bettelheim comes in, puts a straight back chair in the middle of the low stage, and delivers a stimulating lecture without notes, debating controversial questions with students who were practicing speaking truth to power. It is a tad like batting practice – the student throws a fast ball, the Professor gives it a good whack. Whether the reply was a home run or a foul ball continues to be debated. I was in the same lecture, same Professor B, about two years later. Likewise with Professors Victor Turner, David Grene, and Saul Bellow of the Committee on Social Thought. My own mentors were Paul Ricoeur (Philosophy and Divinity) and Stephen Toulmin, who joined the Committee and Philosophy shortly after Turkle returned to MIT.
Full discourse: my dissertation on Empathy and Interpretation was in the philosophy department, but most of my friends were studying with the Committee, who organized the best parties. I never took Bellow’s class on the novel – my loss – because it was credibly reported that he said it rotted his mind to read student term papers; and I took that to mean he did not read them. But perhaps he actually read them, making the sacrifice. We will never know for certain. One thing we do know for sure is that empathy is no rumor in the work of Sherry Turkle. Empathy lives in her contribution.
(c) Lou Agosta, PhD, and the Chicago Empathy Project
The Evidence: Empathy is Teachable, Trainable, Learnable
This essay is an excerpt from Chapter Four of the book Empathy Lessons. This essay is motivated by the need to debunk the position that the practice of empathy is vague and fuzzy and cannot be taught, that you either have it or you don’t. Bunk. I am addressing scientists, researchers, health care professionals who dismiss empathy as not scientific of evidence-based.
Substantial evidence is available that if you practice empathy, you get better at it. A bold statement of the obvious? Indeed. Yet the requirement to marshal the evidence is a significant one, even if it is often a function of resistance to practicing a rigorous and critical empathy. Key term: resistance to empathy. Overcome the resistance to empathy and the practice of empathy spontaneously and naturally comes forth. [See Empathy Lessons and other books by Lou Agosta on empathy: https://amzn.to/2S0ISPr.%5D
Evidence-based empathy
Even if one understands “evidence” in the most narrow and rigorous sense, substantial evidence is available from peer-reviewed research and publictions that empathy training is effective. The implications for evidence-based empathy training are direct. Empathy works. Some of this material may seem difficult or complex; but it is important to engage with it, because it undercuts the subtle resistances to empathy that dismiss empathy in the misguided belief that there are no evidence-based peer reviewed publications.
The first example is an empathy intervention so short that it passed the Institutional Review Board (IRB) criteria for the use of human subjects. The study was complete before people had a chance to drop out. An advertisement went out for people to receive a complimentary, free screening and short intervention for “problem drinking.” In fact, only problem drinkers responded.
The people were divided randomly into groups and given either an immediate check up with confrontational counseling that directed them to stop drinking; or the subjects were given a check up with motivational interviewing that used client-centered counseling and did not try counsel changing the client’s behavior, but in the manner of motivational interviewing explored the person’s motives with him or her. Motivational interviewing employs empathic methods of listening and questioning and, in this example, becomes a proxy for empathy.
Strictly speaking, the counselor facilitated a dicussion with the client of what might happen if the client either did or did not stop (reduce) drinking. A third group of clients was wait-listed, for control, without intervention. Motivational interviewing is a client-centered intervention that relies on empathic listening, questioning, and responding.
Both groups that received intervention resulted in a 57% reduction in drinking within six weeks, and the result was sustained at 1 year. However, there was one dramatic finding. The lead researcher and author (William Miller) reports: “Therapist styles did not differ in overal impact on drinking, but a single therapist behavior was predictive (r = .65) of 1-year outcome such that the more the therapist confronted, the more the client drank.”[i]
This bears repeating: the more confrontational the counselor, the more the client drank. If one starts with a confrontational approach rather than empathy, one is headed for trouble.
In another study, perspective taking was practiced in which the other person was imagined to be a neighbor or a member of one’s own community rather than a stranger.[ii] This examines empathic interpretation, though the study does not use that terminology. Practice perspective taking, it improves.
Other practitioners have developed exercises that focus on specific groups such as doctors of individuals with autism. This expands empathic understanding, though, once again, the terminology is different. Other experiments conduct explicit training in mentalizing, specifically, teaching participants in the training about associations between target facial expressions and emotions.[iii]
In a separate study, a large meta analysis by the Cochrane Library that reviewed fifty-nine peer-reviewed studies with 13,342 participants of a motivational interviewing intervention based on empathy for substance abuse over against other active interventions or no intervention and produced a similar result: motivational interviewing helped people cut down on drugs and alcohol.[iv]
Still, the debate goes on.
Is the empathic questioning, the back-and-forth conversation, in the motivational interview that causes something (attitude, hope, fear, and so on) in the client to shift? Or do people convince themselves? Or do they just get better informed? Or do they stop blaming themselves and feel better, and so they “self medicate” less with alcohol or street drugs?
Lots of questions. No easy answers. Yet when something is so effective across so many studies and researchers are still skeptical, then one has to say: “Okay, skepticism is proper and scientific. Yet nothing is wrong here; but there is something missing—empathy.”
Let’s do the numbers.
Evidence shows that those who train and practice being empathic succeed in expanding their empathy. Educational programs that target empathy have a demonstrably positive effect on empathy skills, according to peer reviewed studies.[v]
Another case in point: a meta analysis of 17 empathy nursing courses in an educational context indicated statistically significant improvement in empathy scores in 11 of the 17 studies (and non statistically significant improvements in the other 6). Similar positive outcomes were reported when medical students, training to be doctors, were included. When nurses and medical students work at practicing empathy; and they get better at it. How about that.[vi]
A disturbing factoid: The empathy of persons studying to become physicians peaks in the third year of medical school according to measures applied periodically (as reported by Dr. M. Hojat and his colleagues at Thomas Jefferson University).[vii] Empathy expands; but then it seems to contract. The suspicion is that the burnout occurs in the “college of hard knocks.”
Use it or lose it? The stereotype of the harried medical doctor, seeing twenty or thirty patients a day, is increasingly accurate. As the MD (or other health care professional) is pushed down into survival mode, empathy is not improved or expanded. Hear me say it, and not for the last time, the things that make us good at the corporate transformation of American medicine, improving productivity and efficiency, do not expand our empathy. This does not mean that empathy and efficiency are mutually exclusive. It means we have to get better at balancing quantity and quality in both business and empathy.
In another example, training sessions directed at aggressive adolescent girls in a residential treatment center showed the benefits of expanded affective empathy. Affective empathy is the automatic dimension of empathy (“empathic receptivity” in my definition) that is perhaps hardest to influence.[viii] Parental effectiveness training (PET) was demonstrated to move the participants from below facilitative on the Truax Accurate Empathy Scale up to or beyond the facilitative level. “Facilitative” means knowing how to get things done. That is, the outcome is that the parent’s empathic effectiveness was expanded.[ix]
The effectiveness of empathy training is not limited to the affective dimension. A team at the University of Toronto produced a meta analysis of twenty-nine articles, using seven different approaches to empathy training. All the studies except two (93%) had positive outcomes, improving the cognitive component of empathy (86%). These studies were distributed as follows: education (24%), nursing (14%), therapy (7%), medicine (21%), social work (3%), psychology (7%), human service (7%), couples (10%) and divorcees (3%). Regardless of the training method, individuals expand their empathy when they practice or engage in effortful training.[x]
In another study, some 42 couples involved in a romantic relationship completed a five week empathy training program. The change in empathy was assessed by measured analyses of variance. The assessment reproduced the positive results of earlier findings. The training produced reliably increased empathic interaction between the partners. Scores on three empathic measures improved over a follow up six month period.[xi]
Further evidence that empathy is trainable is available in “The Roots of Empathy” (ROE). This is a formal program developed by Mary Gordon and colleagues in Canada.
First started in 1996 and introduced into U.S. schools in 2007, the ROE program has been featured on the Public Broadcasting System (PBS) in the USA. ROE aims to build more peaceful and caring communities by expanding empathy in children.[xii]
The program targets elementary school classes, and consists of weekly visits to the class room by a new born baby and the baby’s mother for an entire school year. The group sits in a circle and the mom and baby interact, accompanied by a conversation about the life of the baby, biologically, psychologically, and socially.
The empathy lessons are elementary—unless you do not happen to have ever been exposed to a baby or the empathic care of one. Babies cry when they are hungry or wet or cold; they coo and gurgle and giggle when they are content and happy.
Some lessons are elementary; some, sophisticated, engaging with human development, of which the baby is Exhibit A, as the baby grows throughout the school year.
The roots of empathy are present in front of the class: the baby. The powerful presence of the baby calls forth the emotional resonance, natural curiosity, and wonder of the children. The baby provides the empathy lessons, in effect being the teacher. The baby provides the opening for conversations with the children about human development, socialization, and building a community. The vast majority of human beings are naturally inspired to care for a baby. Whether people know how to deliver such care effectively is a separate issue, requiring separate training. A complex species, these humans: human beings are naturally empathic just as they are also naturally aggressive.
At the heart of this kindergarten through 8th grade program is the goal of dialing down aggressive behavior patterns in children at an early age, in particular, curbing bullying (about which more in an entire chapter below). For example, roughly 160,000 children miss school every day “due to fear of an attack or intimidation by other students,” according to the National Education Association.
The program also documents an 11% improvement in standardized achievement tests for the class that is exposed to the Roots of Empathy intervention.[xiii] This is definitely not a predictable result. It should put us in touch with the humbling sense that there are many things that we do not even know we do not know.
When kids get the empathy to which they are entitled, they study harder and work smarter. When bullying is reduced, kids are less fearful, are less distracted, have more fun, and are able to study. When they study harder and smarter, they get improved scores.
The results of the program are “over the top” positive; and since this is the age of evidence-based everything, the program also spend a lot of cycles gathering key metrics on the results of the roots of empathy. A randomized control trial was conducted.
Findings indicated that children who had participated in the program compared to children who had not, were more advanced in their social and emotional understanding on all dimensions assessed. These included emotional understanding, perspective-taking, peer acceptance, classroom supportiveness, pro-social behavior and characteristics. Concomitant reductions in aggressive behaviors and increases in pro-social behaviors (e.g., helping, sharing, cooperating) were noted.
In particular, teachers rated three child (student) behavior outcomes (physical aggression, indirect aggression, and pro-social behavior). The Roots of Empathy program had statistically significant and replicated beneficial effects on all three child behavior outcomes.[xiv]
Peer reviewed research is compelling, but equally compelling are market dynamics: organizations are voting with their dollars that empathy is trainable.
People with chronic life style diseases such as hypertension (high blood pressure), type 2 diabetes, congestive heart failure, asthma, and so on, enjoy statistically favorable outcomes when their physicians show empathy—a fancy way of saying people “get better.”
Relying on such evidence, a company called “Empathetics” has been founded to train medical doctors in expanding their empathy.
Using intellectual property developed at Massachusetts General Hospital, affiliated with Harvard University, Empathetics, Inc. trains physicians in expanding their empathy through the use of biofeedback.
The CEO, Helen Riess, MD, delivered a Ted Talk about the value of empathy in health care.[xv] Dr. Riess and her colleagues at Mass General performed a meta analysis of the effects of empathy on all kinds of diseases.
Dr. Riess (and her colleagues) report on randomized controlled trials (RCTs) in adult patients, in which the patient-clinician relationship was systematically monitored and healthcare outcomes were either objective (e.g., blood pressure) or validated subjective measures (e.g., pain scores). Those doctors (and related professionals) that scored higher on the empathy screening tests had demonstrably better patient outcomes than those with lower empathy scores.
Three trials included patients with diabetes, two included patients with osteoarthritis. Other disorders included fibromyalgia, oncology, lower respiratory infection, osteoarthritis, hypertension, smoking, somatic complaints, and asthma. The median patient sample size was 279 (range: 85 to 7,557). That’s a lot of people.
In summary, empathic doctoring produces favorable results. Patients get better compared with those whose doctors who do not score as well on the applied empathy scale. A word of caution. Correlation points to a significant path to improved outcome through empathic relatedness, but, at least in the context of this study, correlation is not causation.
Using the language of evidence-based medicine is trending. The “effect size” of empathy is so large that it overwhelms any confounding variables that might be hiding beneath the surface of experience. Thus, empathy fits right in with the trend. The results are compelling. Applying empathy in interacting with the vast majority of people is like using penicillin to treat the vast majority of significant bacterial infections. Applying empathy in interacting with people is like using a parachute when jumping out of an airplane. If you don’t do it, you are headed for trouble.
Common factor, empathy, in social healing practices
Psychotherapy is regarded as an example of a social healing practice. Psychotherapy is a conversation for possibility between two persons, one of whom is dealing with difficult personal issues and emotions and another person who is committed to making a difference through empathy.
Experience shows that physical disorders, injuries, and lesions get elaborated psychosocially. This is not just hypochondria or imaginary disorders that are “in someone’s head.” This is lower back pain, migraines, life style disorders such as type 2 diabetes, asthma, and irritable bowel that are aggravated by job, family, and relationship issues (conflicts, stresses, upsets) in a person’s life. Nutrition and exercise are behavioral practices that positively affect health, but can be difficult to influence.
People have different ways of expressing their pain and suffering. When an investigation of the person’s life indicates that non-biological factors are contributing to the person’s decline or distress, then it is useful to engage an alternative point of view on pain and suffering. It is useful to undertake an inquiry without making too many assumptions that one knows what is actually going on. It is useful to have a conversation for possibility.
The first person to undertake such an inquiry of whom we have any record was named “Socrates.” His student, Plato, wrote down what Socrates had to say, the most famous statement of which was that he knew only one thing: “I know that I do not know.” Socratic’s approach was so powerful that he was able to undertake fundamental inquiries that challenged his own inauthenticities and those of the persons with whom he engaged in dialogue. His questioning led to insights about basic values of truth, right and wrong, pleasure and enjoyment, and the organization of the community. The example of Socrates inspired talk therapists of all kinds—not to mention religious leaders, politicians of integrity, and educators in diverse disciplines.
The word “empathy” does not occur in Plato’s dialogues with Socrates, who instead spoke of being a “midwife” of ideas. When a friend of mine read this account of Socrates as a midwife, he shared with me an anecdote from when he was a medical student. He was walking through the hospital maternity department one evening after class. As he passed an open door, one of the patient’s called out to him. She was in labor and she asked his help. As he told me candidly, at that time in his medical training, he knew nothing about childbirth. Thus, as far as he was concerned, the qualification of Socratic ignorance was satisfied.
My friend asked the woman how he could help. She asked to hold his hand. He thought to himself, “Now this I know how to do!” He held her hand for awhile. She pushed and pushed. The result was a healthy baby boy. How or why the woman was left alone, and what further help arrived was not specified.
My friend cited this as an example of empathic understanding that just shows up spontaneously. In his recollection this was an example of empathy at a moment of crisis to which no words were adequate. I would say the woman was training him in being empathic, and the empathy lesson worked just fine.
Socrates did not claim to produce original knowledge himself. But he acted as a midwife for others, who were trying to give birth to sustainable, viable knowledge. In terms of empathic understanding, Socrates exemplified the commitment to new possibilities as opposed to conformity. Socrates made the case for dwelling in the comfort-zone stretching, discomfort of open-ended inquiry in the face of “being right.” He helped his dialogue partners give birth to ideas of their own and distinguish those ideas that are viable from those that are still-born.
Socrates enjoyed a special relationship with his students and colleagues. He had a special rapport that was a combination ofidealization and affection that set him apart from many of the other teachers of his time, called “Sophists.” The latter were masters of argumentation and rhetoric for hire.
The sophists were perhaps the original purveyors of “alternative facts” and “fake news.” Socrates’ relationship with the sophists in the community was not positive. He spoke truth to power in such a way that those in power were deeply threatened. Some of those in authority came to fear and hate him.
Eventually Socrates was indicted and convicted, in a trial of questionable merit, of a crime against the state, corrupting the youth. For reasons that are still controversial today, Socrates decided to drink the hemlock instead of fleeing into exile, becoming a martyr to prejudice and political intrigue.
Nevertheless, the principles that Socrates espoused have become the basis for talk therapy—and overcoming resistance to empathy. To engage in therapy with human beings in their struggle with emotional pain and suffering requires: providing a gracious and generous listening and an authentic human response; inquiry into possibility and open-ended questioning; an alliance between the therapist and client against the disorder and suffering against which the client is struggling; and an understanding of cultural context and community.
Amid an alphabet soup of therapeutic approaches today, the Socratic method of inquiry stands out as a common factor. It is challenging to try to find something in common between cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), eye movement desensitization routine (EMDR), rational emotive behavioral therapy (REBT), acceptance and commitment therapy (ACT), psychodynamic therapy, psychoanalysis, existential and humanistic psychotherapy, and so on.
“Common factor” is an idea given credibility by Jerome and Julia Frank in their book on Persuasion and Healing.[xvi] The Franks debunk not only psychoanalysis, but also many of the alternative therapeutic approaches. The Franks’ position is that the beneficial results of therapy are a function of persuasion and suggestion. The therapist is applying his or her own empathic and emotionally generous personality in the context of the trusted relationship, committed to healing, to persuade the client to alter his habitual life practices in the direction of behaviors that are adaptive, accommodating, and empowering. The hypnotists called it “the rapport”; modern practitioners, “the therapeutic alliance.”
However, the point here is not to back into an advertisement for empathy. Rather the point is to look at what actually happens in stage one of therapy whether it is CBT, DBT, or one of the diverse talk therapies. Each of these interventions, after establishing a framework around schedule and fee, takes steps to deepen and expand the client’s “in touchness with” his or her own experiences. In DBT this is called “mindfulness”; in psychoanalysis, “free association”; in CBT and REBT, identifying and “interrupting the pathogenic thought”; in existential-humanistic therapy and ACT, “radical acceptance” of what’s so.
This “getting in touch with” is also the first step in becoming more empathic, and so highly relevant to empathy training. One has to be in touch with one’s own experiences in order to appreciate how the other person shows up in one’s vicarious experiences of that other person. In short, empathy is a common factor shared by virtually all approaches to talk therapy.
The problem is that grouping empathy with “common factors” has become a way of dismissing empathy. All the interventions share empathy. It occurs on all sides of the multi-dimensional equation, and so empathy itself cancels out. Empathy falls out of the equation—and out of the discussion.
I suggest an alternative point of view.
What if empathy were the very process that was creating the benefit—and the very equation itself—for each of these supposedly distinct interventions? What if empathy were the very thing that was creating the clearing for EMDR, ACT, and so on, to be effective in the person’s shifting out of stuckness, attachment to suffering, emotional disregulation, self-defeating behavior, or repetitive enactment?
What if empathy was not the idle wheel, falling out of the equation, but the drive shaft? What if the techniques of CBT, DBT, ACT, EMDR, and so on, were themselves so much formal scaffolding, providing a ritual framework for the dynamics of the empathic relatedness to have its effect?
Following the baton or dancing light in EMDR would be something to keep the client distracted while he was verbally expressing his experience of the trauma into the gracious listening of the therapist.
Filling out the paperwork, the surveys, and the homework of CBT would be so much busy work designed to keep the client’s mind off of his anxiety and depression for long enough for the therapist’s empathic responses to the client’s issues to have an impact.
The breathing in and out of mindfulness, literally a metaphor for empathy as oxygen for the soul, would be a useful holding pattern enabling the client to get in touch with his experience so he can communicate it to the therapist and be “gotten” for who he is as the possibility of radical acceptance in empathic understanding.
The “tough love” of DBT and the group skills back-and-forth would be a useful distraction for the client’s intolerable emotions until the therapist was either able to get it right with his empathic interpretation or the client exhausted the payer’s twelve approved sessions. Then, in every case, the empathic exchange as it occurs in the conversation between therapist and the client would be what is making the difference.
More work is definitely needed on this hypothesis. Nor is it likely to be an “either/or” matter. CBT’s “trigger log,” “dysfunctional thinking report,” and “daily thought record,” are useful exercises. Highly useful. It is just that, absent empathy, the CBT process is indistinguishable from dental work—and then the client does not even do the “homework.” What would an evidence-based comparison between empathic and alternative interventions even look like?
The client comes in, and the therapist greets him with a standard human response, using all her abilities to understand and grasp that with which the other person is struggling. Is one supposed to compare being empathic with being rude? With being hard-hearted? With being confrontational? With misunderstanding the other person? With being stone-faced and unemotional? All of these are possibilities. The stone-faced option has actually been tried, but not with adults presenting for therapy. Presumably because it would be a short session. The adults would not stand for it, and most (possibly excepting the masochistic) would get up and walk out.
However, it has been tried with infants in the context of attachment studies. When infants are briefly presented with a “still face,” a blank face from which emotion has been removed on the part of care-takers, who are usually warm and welcoming, the infants become noticeably upset. Some start to fuss; others, to cry. So do most people, whether in personal or experimental situations such as being on “candid camera.” Babies and children of tender age are people, too, and I suggest that their response is an example of a standard human one, albeit without any grammatical use of language, and typical of what one might expect from adults.
What is clear is that an overwhelming number and diversity of psychotherapy approaches engage in the use of empathy. This is so even when these interventions allow empathy subsequently to fall out of the equation as a “common factor.”
Even if the approach in question devalues empathy as a narrow psychological mechanism, it has to endorse its use, because when empathy is absent, generally, positive outcomes are also absent. Those few interventions that devalue empathy—electro shock therapy (ECT), shaming, jail, capital punishment, collective shunning—begin by paying it rhetorical lip service. The result? The amount of aggregated experience that indicates that empathy is an effective intervention is vast and arguably sufficient to overcome any hidden, confounding variables.
Judgments based on clinical practice, tacit knowledge, and deep life experience will continue to have a essential role; however, these need to be qualified by the best available evidence. As noted, the issue is that there are some interventions such as penicillin and using a parachute when jumping out of an airplane that seem to limit or even defy the gold standard. It would be unethical not to give someone penicillin if they were infected with an infection serious enough to require such treatment, since it is a matter of historical accident that penicillin was invented prior to the “evidence based” paradigm shift. And, as regards using a parachute, that case is the reduction to absurdity of not using common sense as a criteria in deciding what counts as evidence. What is going on here? The answer bears repeating for emphasis: The effect size is so large that it outweights and overwhelms any hidden confounding factors and so rises to the level of evidence (without quotation marks). [xvii]
The “effect size” is a function of the facts—the evidence—that there are so many examples and so much experience that penicillin works—that parachutes work—that the risk of one’s over-looking some other confounding variable is vanishingly small. It really was the penicillin, not (say) the effects of the alignmnet of the planets hidden behind the penicillin.
Likewise, with empathy. The use of empathy in human relations is demonstrably so effective in the medical and behavioral health world in question that not to apply empathy would be like not prescribing antibiotics against a bacterial infection. Empathy has been effective in shifting the suffering and transforming the psychic pain throughout history. The criticism of empathy has usually been that it results in burnout and compassion fatigue. But penicillin, too, has to be properly dosed, and people allergic to it excluded, or the results will be unpredictable.
In conclusion, the critical path lies through empathy training: empathy is not an on-off switch but a dial/tuner that requires training to get it just right. Examples of peer-reviewed publications exist in which empathy was shown to be effective (in comparison with less empathy) in correlating with favorable outcomes in diabetes, cholesterol, and the common cold (?!) and are cited in the bibliography (and will be further engaged in Chapter Six of Empathy Lessons).[xviii] Expect this work to expand and gain traction in other areas such as psychiatry and cognitive behavioral therapy.
In short, not to begin with empathy would be like jumping out of the airplane without a parachute or not providing penicillin when the infection was bacterial. If you are jumping out of an airplane, use a parachute; if engaging with struggling, suffering humans, use empathy.
[i] W.R. Miller, R.G. Benefield, J.S. Tonigen. (1993). Enhancing motivation for change in problem drinking: a controlled comparison of two therapist styles, Journal of Consultative Clinical Psychology, June; 61 (3): 455-61: 455.
[ii] Jay S. Coke, Gregory Batson, Katherine McDavis. (1978). Empathic mediation of helping: A two-stage model, Journal of Personality and Social Psychology 36(7):752–766. DOI: 10.1037/0022-3514.36.7.752; Mark H. Davis, Laura Conklin, Amy Smith, Carol Luce. (1996). Effect of perspective taking on the cognitive representation of persons: A merging of self and other, Journal of Personality and Social Psychology, Vol 70(4), Apr 1996: 713–726.
[iii] Ofer Golan and Simon Baron-Cohen. (2006). Systemizing empathy: Teaching adults with Asperger syndrome or high-functioning autism to recognize complex emotions using interactive multimedia, Development and Psychopathology 18, 2006: 591–617. DOI: 10.10170S0954579406060305; J. Hadwin, S. Baron-Cohen, P. Howlin, and K. Hill. (1997). Does teaching theory of mind have an effect on the ability to develop conversation in children with autism? Journal of Autism and Developmental Disorders, 27: 519–537. DOI:10.1023/A:102582600 9731.
[iv] Geir Smedslund, Rigmor C. Berg, Karianne T. Hammerstrom, Asbjorn Steiro, Kari A Leiknes, Helene M Dahl, Kjetil Karlsen. (2011). Motivation interviewing for substance abuse, Cochrane Database of Systematic Reviews, May 11, 2011, Issue 5: CD 008063. DOI: 10.1002/12651858.CD008063.pub2.
[v] C.T. Ozcan, F. Oflaz, B. Bakir. (2012). The effect of a structured empathy course on the students of a medical and a nursing school, International Nursing Review, Vol. 59, Issue 4, December 2012: 532–538. DOI: 10.1111/j.1466-7657.2012.01019.x.
[vi] Scott Brunero, Scott Lamont, Melissa Coates. (2010). A Review of empathy education in nursing, Nursing Inquiry: Vol. 17, Issue 1, March 2010: 65–74.
[vii] M. Hojat, M. J. Vergate, K. Maxwell, G. Brainard, S. K. Herrine, G.A. Isenberg. (2009). The devil is in the third year: A Longitudinal study of erosion of empathy in medical school, Academic Medicine, Vol. 84 (9): 1182–1191.
[viii] E.V. Pecukonis. (1990). A cognitive/affective empathy training program as a function of ego development in aggressive adolescent females, Adolescence, Vol. 25: 59–76.
[ix] Mark E. Therrien. (1979). Evaluating empathy skill training for parents, Social Work, Vol. 24, no. 5 (Sep 1979): 417–19.
[x] Tony Chiu, Ming Lam, Klodiana Kolomitro, Flanny C. Alamparambil. (2011). Empathy training: Methods, evaluation practices, and validity, Journal of MultiDisciplinary Evaluation, Vol. 7, No. 16: 162–200.
[xi] J..J. Angera and E. Long. (2006). Qualitative and quantitative evaluations of an empathy training program for couples in marriage and romantic relationship, Journal of Couple & Relationship Therapy, Vol. 5(1): 1–26.
[xii] PBS staff reporter. (2013). Using babies to decrease aggression and prevent bullying. PBS News Hour: http://www.pbs.org/newshour/rundown/using-babies-to-decrease-aggression-prevent-bullying/
[xiii] PBS staff reporter 2013.
[xiv] Mary Gordon. (2005). The Roots of Empathy: Changing the World Child by Child. New York/Toronto: The Experiment (Thomas Allen Publishers): 250–256.
[xv] Helen Riess. (2013). The power of empathy, TEDxMiddlebury: https://www.youtube.com/ watch?v=baHrcC8B4WM [checked on March 23, 2017]. See also: John M. Kelley, Gordon Kraft-Todd, Lidia Schapira, Joe Kossowsky, Helen Riess. (2014). The influence of the patient-clinician relationship on healthcare outcomes: A systematic review and meta-analysis of randomized controlled trials, PLOS, Vol. 9, No. 4 | e94207: 1–7 Helen Riess, John M. Kelley, Robert W. Bailey, Emily J. Dunn, and Margot Phillips. (2012). Empathy training for resident physicians: A randomized controlled trial of a neuroscience-informed curriculum, Journal General Internal Medicine. 2012 Oct; Vol. 27(10): 1280–1286. DOI: 10.1007/s11606-012-2063-z.
[xvi] Jerome D. Frank and Julia B. Frank. (1981). Persuasion and Healing: A Comparative Study of Psychotherapy. 3rd ed. Baltimore: Johns Hopkins University Press; 1991. I express appreciation to Danny Levine, MD, for calling my attention to this outstanding contribution from the Franks. Also see my A Rumor of Empathy: Resistance, Narrative, and Recovery (2015) for a critique of the psychopharmacological (psychiatric) approach in chapter three “Plato, Not Prozac!” (a title that I borrow from Lou Marinoff (2000), who I hereby acknowledge for his contribution).
[xvii] Howick 2011: 5, 11.
[xviii] Howick 2011; M. Hojat et al, 2011; John M. Kelley, Helen Riess et al 2014); David P. Rakel, Theresa J. Hoeft, Bruce P. Barrett, Betty A. Chewning, Benjamin M. Craig, and Min Niu. (2009). Practitioner empathy and the Duration of the common cold, Family Medicine 41(7): 494–501.
(c) Lou Agosta, PhD and the Chicago Empathy Project
Empathy is good for your health and well-being (The evidence)
Empathy is good for your health and well-being: Empathy is on a short list of stress reduction practices including meditation (mindfulness), Tai Chi, and Yoga. Receiving empathy in the form of a gracious and generous listening is like getting a spa treatment for the soul. But do not settle for metaphors.
For evidence-based research on empathy, empathy and stress reduction, and empathy training you may start by googling: Antoni et al. 2011; Ciaramicoli 2016; Del Canale et al 2012; Farrow et al. 2007; Irwin et al. 2012; Maes 1995, 1999; Pollack et al. 2002; Rakel et al. 2009; Segerstrom and Miller 2004; Slavich et al. 2013 [this list is not complete].
You do not have to buy the book, Empathy Lessons, to get the research, but if you would like more detail see especially Chapters Four and Six in Empathy Lessons (click here to get book from Amazon).
[Also included are chapters on the Top 30 Tips and Techniques for Expanding Empathy, Overcoming Resistance to Empathy, Empathy Breakdowns, Empathy as the New Love, Empathy versus Bullying, and more.]
The healing powers of stress reduction are formidable. Expanding empathy reduces stress; and reducing stress expands empathy. A positive feedback loop is enacted. Expanding empathy expands well-being. Here empathy is both the end and the means.
A substantial body of evidence-based science indicates that empathy is good for a person’s health. This is not “breaking news” and was not just published yesterday. We don’t need more data, we need to start applying it: we need expanded empathy.
Evidence-based research demonstrates the correlation between health care providers who deliver empathy to their patients and favorable healthcare
outcomes. What is especially interesting is that some of these evidence-based studies specifically exclude psychiatric disorders and include mainline medical outcomes such as reduced cholesterol, improved type 2 diabetes, and improvement in related “life style” disorders.
Generalizing on this research, a small set of practices such as receiving empathy, meditation (mindfulness), yogic meditation, and Tai Chi, promote well-being by reducing inflammation. These practices are not reducible to empathy (or vice versa), but they all share a common factor: reduced inflammation. These anti-inflammatory interventions have been shown to make a difference in controlled experiments, evidence-based research, and peer-reviewed publications.
Using empathy in relating to people is a lot like using a parachute if you jump out of an airplane or getting a shot of penicillin if one has a bacterial infection. The evidence is overwhelming that such a practice is appropriate and useful in the vast majority of cases. The accumulated mass of decades of experience also counts as evidence in a strict sense. Any so-called hidden or confounding variables will be “washed out” by the massive amount of evidence that parachutes and penicillin produce the desired main effect.
Indeed it would be unethical to perform a double blind test of penicillin at this time, since if a person needed the drug and it were available it would be unethical not to give it to him. Yes, there are a few exceptions – some people are allergic to penicillin. But by far and in large, if you do not begin with empathy in relating to other people, you are headed for trouble.
Empathy is at the top of my list of stress reduction methods, but is not the only item on it. Empathy alongwith mindfulness (a form of meditation), Yoga, Tai Chi, spending time in a sensory deprivation tank (not otherwise discussed here), and certain naturally occurring steroids, need to be better known as interventions that reduce inflammation and restore homeostatic equilibrium to the body according to evidence based research.
Biology has got us humans in a bind, since the biology did not evolve at the same rate as our human social structures. When bacteria attack the human body, the body’s immune system mounts an inflammatory defense that sends macrophages to the site of the attack and causes “sickness behavior” in the person. The infected person takes to bed, sleeps either too much or too little, has no appetite (or too much appetite), experiences low energy, possibly has a fever, including the “blahs,” body aches, and flu-like symptoms. This response has evolved over millions of years, and is basically healthy as the body conserves its energy and fights off the infection using its natural immune response.
Now fast forward to modern times. This natural response did not envision the stresses of modern life back when we were short stature, proto-humanoids inhabiting the Serengeti Plain and defending ourselves against large predators. Basically, the body responds in the same way to the chronic stressors of modern life—the boss at work is a bully, the mortgage is over-due, the children are acting out, the spouse is having a midlife crisis—and the result is “sickness behavior”—many of the symptoms of which resemble clinical depression—but there is no infection, just inflammation.
The inflammation becomes chronic and the body loses its sensitivity to naturally occurring anti-inflammatory hormones, which would ordinarily kick in to “down regulate” the inflammation after a few days. Peer reviewed papers demonstrate that interventions such as empathy reduce biological markers of inflammation and restore equilibrium. This is also a metaphor. When an angry—“inflamed”—person is listened to empathically—is given a “good listening” as I like to say—the person frequently calms down and regains his equilibrium.
Empathy migrates onto the short list of inflammation reducing interventions. The compelling conclusion is that empathy is good for your well-being.
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(c) Lou Agosta, PhD and the Chicago Empathy Project
The case of Dr Know-it-all: Empathy gives us our humanity
You do not need a philosopher to tell you what empathy is. What then do you need? How about a folktale, a fairy tale, a narrative, a Märchen?
Rather than start with a definition of empathy, my proposal is to start by telling a couple of stories, in which empathy (and its breakdown) plays a crucial role. Both stories are anonymous folktales from the collection edited by the Brothers Jacob and Wilhelm Grimm. The distilled wisdom of the ages accumulated in traditional anonymous narratives will do nicely. Both stories include a significant amount of humor, underscoring that humor and empathy are closely related (on humor and creating a community see also Ted Cohen’s book Jokes (1999)).
How so? In both humor and empathy one crosses the boundary between self and other while preserving that boundary. In both humor and empathy one builds a community, even if only of two people, by transiently, temporarily weakening the boundary between self and other, then reestablishing it. In the case of humor, the boundary crossing is loaded with an element of aggression, violation of community standards, or sexuality—the source of the tension that is released in laughter—whereas with empathy proper the boundary is traversed with a respectful acknowledgement and communication of mutual humanity, whether as high spirits, suffering, or community expanding affinity and affection.
I hasten to add that while the philosopher does not necessarily have a better mastery of empathy than any parent, teacher, doctor, nurse, first responder, therapist, flight attendant, business person with customers, professional with clients, and so on, the philosopher is useful—and at times indispensable—in clarifying distinctions, analyzing concepts, and disentangling misunderstandings about empathy.
Thus, the fairy tale (Märchen) of Doctor Know-it-all is a perfect place to start a philosophical inquiry into

Image credit:
John Thomas Smith / Wellcome V0020405.jpg (Creative Commons Attribution 4.0)
empathy. An uneducated, illiterate, hungry peasant named “Herr Crabb” delivers a load of wood to a doctor.[1] Crabb observes the doctor eating a sumptuous lunch; and Crabb asks him how he (Crabb) might improve his station by becoming a doctor. The doctor tells him to sell his ox and cart and buy an ABC book, buy a fine suit of clothes, and put a sign in front of his hovel that says “Dr Know-it-All.” (Note that the English “Know-it-all” is a translation of the German “allwissend,” which is also the standard translation of the divine attribute “omniscient.”)
Scene two: thieves steal the treasure from the rich noble lord of the manor on the hill. Dr Know-it-all is called in to consult on the case, solve the crime, and recover the treasure.
Now getting a good meal is a recurring theme in this story, and Crabb insists on beginning the consulting engagement by coming to dinner. The nobleman, Crabb, and Crabb’s wife, sit down to a fine three-course meal served by the nobleman’s servants. The first servant brings in the first covered dish, and Crabb says, “That is the first.” Likewise with the other two courses: “That is the second” and “That is the third.”
Now the servants are starting to get worried, because, as is sometimes the case with such crimes, the theft was an inside job, and the servants were ones who did it. “This Crabb guy seems to be onto us,” say the servants to one another between courses. Meanwhile, the nobleman challenges Crabb to say what is under the third covered dish, testing Crabb’s credential as Dr Know-it-all. Of course, Crabb has no idea, and in frustration, he gestures as if to slap himself in the head and says his own name “Oh, Crabb!” Right! The meal is of crab cakes.
Now the servants are really worried—this guy really does know-it-all. The servants create a pretext to take Crabb aside and confess their theft to him, telling him that they will tell him where the treasure is hidden and even give him an extra fee in addition if only he does not identify them as the culprits. An agreement is reached. Crabb shows the lord where his treasure is hidden, collects ample fees from all sides, does not betray the servants, who, after all, are fellow suffers of social injustice like Crabb himself, resulting in the latter’s becoming rich and famous. By the end of the story, living into a self-fulfilling prophecy, as his performance catches up with his reputation, Crabb does indeed become Dr Know-it-all.
This is the perfect narrative with which to begin an engagement with a group of philosophers and thinkers who propose answers about the core issues in the study of empathy. One could let one’s scholarly egoism result in a narcissistic injury; but a better response would be self-depreciating humor. The occupational hazard of over-intellectualization looms large whenever philosophers sharpen the cutting edge of their analytic tools. And there is nothing wrong with that as such, but the approach does have its risks and constraints.
Philosophically speaking, the peasant Herr Crabb, Dr Know-it-all, is the personification of our Socratic ignorance. Socrates’ fame was assured when the Oracle at Delphi—a kind of latter day Wikileaks—proclaimed him as the wisest person in the world, because he acknowledged (i.e., knew) that he did not know.
Socrates was a commitment to pure inquiry; and that has remained a valid approach to philosophizing in such thinkers as Wittgenstein, Nietzsche, Hume in his skeptical phase, and the Kant of the transcendental dialectic. Nevertheless, the commitment of this review is to provide both questions and answers about empathy, in a Socratic spirit, even if those answers then become the basis for further debate, argument, and inquiry.
Meanwhile, the story of Dr Know-it-all is meant to be told with a totally strait face. Notwithstanding the relatively primitive state of medicine in 1804, one still had to go to the university, even if only the better to understand how the planets influenced disease as in influenza. Nevertheless, it is a depreciating and mocking guidance that the doctor gives in the opening scene to the peasant to sell his ox and get a sign that says “Dr Know-it-all.” The peasant follows the advice.
This is the first empathic encounter in the story. Crabb brings the mind of a beginner to the relationship. In a “once upon a time” moment, this is Crabb’s Socratic ignorance, though of course the story does not use such language. Crabb often seems to be thinking about his next meal, and, in that limited sense, he has a desire—to be well fed like the ruling class. However, in a deeper sense, Crabb is without desire and without memory. That is empathy lesson number one in this story: bring the innocence of a beginner’s mind to one’s relationships. That is the readiness assessment for empathy: be open to possibility, no matter how unlikely or counter-intuitive.
Next, in a series of seeming coincidences, Crabb makes simple, ambiguous statements such as: “That is the first one,” “That is the second one,” and so on. These statements become ambiguous Gestalt figures like the famous duck-rabbit, which spontaneously reverses between one figure and another, depending on one’s perspective. Is it a duck or is it a rabbit? (For an image of the duck-rabbit see Wittgenstein 1951: 194 (or Google it).) Likewise, in the folktale, does the statement refer to the dish of food being served or to the answer to the discussion question, who is the thief? Yes.
This is top-down cognitive empathy; take a walk in the other person’s shoes. The servants employ top down empathy—imagining that they are the consultant(s) brought in to solve the mystery of the missing treasure, taking Crabb’s perspective, putting themselves in his shoes. But their empathy misfires. It doesn’t work. Instead of taking a walk with the other person’s personality—Crabb is after all a poor peasant like the servants (but they do not necessarily know that)—they project their own issue onto Crabb.
Their issue? The servants know who are the thieves and they have one thought too many about it. They have guilty consciences. Though they are hungry peasants in their own way, they identify with the values of the dominant class. When authentic human relatedness misfires, then one gets the psychological mechanism of projection. The thieves guiltily project their knowledge onto Crabb. They imagine that Crabb knows their secret. Here the servants’ empathy is in breakdown. The readers learn about empathy by means of its misfiring, breaking down, going astray, and failing.
Taking a step back, the fundamental empathic moment is so simple as to be hidden in plain view. Crabb’s empathy tells him what the servants are experiencing. Fear. They are afraid. If Crabb identifies them as the thieves, they will be hanged. The servants actually say that to Crabb in the story.
Note this is a world circa 1804 in Central Europe, in which there is a different set of rules for judging servants and noblemen. When a nobleman steals, it is called rent, taxation, or user fees. When the servants steal, it is a hanging offense. Theft remains a transgression, so the treasure must be returned. But when the hungry steal to eat, it is arguably a much less serious offense if not an actual entitlement. “Cast not the first stone: go—and sin no more.”
So the story also belongs to a type in which the servant outwits the master, a type of which The Marriage of Figaro is perhaps the most famous example. (See also the narrative approach of Jerzy Kosiński’s Being There, a major motion picture that features Peter Sellers as a naive gardener educated only by watching TV.) In our narrative, integrity is restored at multiple levels. The treasure is returned, the peasant Crabb and his wife acquire the means to eat well going forward, and the servants escape an unfair punishment.
This highly subversive message must be wrappered in humor, so as not to so threaten the prevailing social hierarchy or social injustice of rigid class distinctions with violent revolution. Getting the message out overrides transforming the social order, a perhaps unrealistic expectation in the listening of the folk audience. Crabb’s empathy tells him what the servants are experiencing; his compassion tells him what to do about it—not identify the servants as the perpetrators. I do so like a happy ending, rare though those be.
The case of the young man lacking empathy
The second fairy tale is a kind of thought experiment, a condition contrary to fact. What would be the case if someone completely lacked the capacity for empathy—and how would one acquire such a capacity?
“The story of the youth who set forth to learn fear” is about a young man who is such a simpleton that he does not even experience fear.[2] It is a long and intricate story. I simplify. The folktale is a ghost story. In the story, as people are telling ghost stories, they say “it made me shudder”—a visceral sensation of “goose bumps” in German the onomatopoeic “grüseln.” This simpleton says: “I wish I knew what that was—shuddering. It sounds interesting, maybe I could make a career out of it.” His poor father is now in despair, thinking, “What am I going to do with this one?” Being charitable, we might say nothing is wrong with this young man, the protagonist in the story, but there is definitely something missing.
The father is agreeable. He apprentices the youth out to the local sexton to teach him fear. The sexton tries to scare him by dressing up in a sheet as a ghost at midnight, but the sexton breaks his leg when the youth is not scared and fights back. Thus, the youth is exiled, going on an educational journey into the world to learn visceral fear—shuddering. Having no idea what fear is, he volunteers to spend three nights in the haunted castle, from which no visitor has ever, ever returned alive.
The youth is a simpleton, but one might say, no fool. He takes with him, a knife, a turning lathe with vice grip, and a fire, the three things one is likely to need in case of an emergency. The first night he is confronted by dogs and cats with red-hot chains—the beasts of hell. He uses the knife to dispatch them. The second night he is confronted by fragmentation and dismemberment. Disconnected arms, legs, and heads fall down the chimney, and the zombie-like, quasi-men propose a game of bowling. But the heads, being elliptical, do not roll well. Fearless as usual, he uses the turning lathe to make well-rounded bowling balls, and all enjoy the game.
All the while, the youth is obsessively complaining: “I wish I knew what was shuddering. I wish I could shudder.” On the third night, pallbearers bring in a coffin with the dead body of his cousin. In a scene that authentically arouses the reader’s shuddering, the youth gets into bed with the corpse to warm it up. He succeeds. The corpse comes alive, and, not behaving in a friendly way, threatens to strangle him. But the youth is as strong as he is simple. He overpowers it. Then the old spirit appears, the old man in a long, white beard appears. They struggle. Though consistently depicted as a simpleton, the youth has a breakthrough in his intelligence. Instead of using the physical strength that has served him up until now, the youth cleverly catches the old one’s beard in the vice grip; and he thrashes him until the latter surrenders. The youth wins, and the old spirit shows the youth the treasure hard-to-attain, one third of which goes to the king, one third to the poor, and he gets to keep one third. He also gets the hand of the princess in marriage.
However, the youth has still not learned to shudder. Fear not! On the morning after his wedding night, the chambermaid hears of his persisting complaint from his wife. The chambermaid asserts that the problem is easily fixed. She takes the decorative bowl of gold fish in cold water and throws it on him, as he lies in bed still asleep. The little fish flop around. He awakes. He gets it: Goose bumps. “At last I understand shuddering!”
Fear is perhaps the most primordial and basic emotion. The flight/fight response is a function of the basic biological response of the organism to situations that threaten the integrity of our creaturely existence. The amygdala is activated, adrenalin (norepinephrine) pours into the blood stream, a visceral state of arousal of the body is mobilized that includes increased heart beat, rapid pulse, enhanced startle response, hair standing on end, and a withdrawal of blood from the surface of the skin that results in “goose bumps.” It is a thought experiment similar to riding on a beam of light, going light speed, to imagine a person who does not experience fear in the face of the fearful. Such a thought experiment might not require as much equipment as riding on a beam of light, but, in any case, it is just as rare.
However, no sooner did I pen these words, then I came across a case, in which an individual was identified who did not experience what we would conventionally call “fear.”[3]
As usual, the real world is more complex than one’s thought experiments. It turns out that the individual in question (SM-046) does experience fear in certain situations, but much less so than most “normal” people, so-called “neurotypicals.” The subjective experience of suffocation upon inhaling carbon dioxide in a controlled setting did indeed arouse panic (fear) in her. Panic, fear—close enough?
A further analysis is required to determine what parts of the interpersonal world—personal space, trust of other people, social skills—are impacted (and by how much) by damage to the amygdala. In no sense is SM “less human”; but there is something missing from her empathic repertoire. This missing capacity for fear seems to diminish her social skills and ability to relate. She does not experience vulnerability in situations that are dangerous or risky when most other people would do so, which could be problematic in avoiding injury due to everyday hazards. In that sense, she may actually resemble the simpleton-hero in the folktale, who is so impervious to what others would experience as fearsome or scary that he naively acts courageously and triumphs in the face of long odds against success.
SM does not spend three nights in a haunted castle, so her experiences cannot be compared to those of the protagonist in the folktale. Yet, in any case, physiological fear becomes a symbol of empathic, struggling humanity and its quest for self-knowledge.
The hero-simpleton tries so hard to experience fear that he is effectively defended against his own emotional life. It is ironic that the simpleton is guilty of over-intellectualizing, usually an occupational hazard of philosophers. The youth imagines that someone can tell him in a form of words what is fear as shuddering, visceral goose bumps.
This lack of feeling points to an underlying deficiency in the capability to empathize. Today we might say that this youth is “on the spectrum”—the autistic spectrum—in that he is emotionally isolated and struggles with the reciprocal communication of affect. In short, the youth has an empathy deficit.
As in all classic folktales, the youth has to go forth on a journey of exploration of both the world and of himself. He becomes a traveller on the road of life, which is the narrative of his emotional misadventures to recover his empathy—and his affective life—and become a complete human being.
This must be emphasized. The recovery of feelings is the recovery of his humanity. The youth’s journey into the world can be described in many way; but I urge that it is a journey to recover his humanity in the form of experiencing the full range of human emotions in himself and others, the basic paradigm of which is fear and the basic capacity for which is empathy.
The youth’s recovery of his ability to shudder, his emotions, and his empathy unfold as a running joke. After each increasingly creepy encounter with something most people describe as fearful, he complains, “I wish I could shudder.” This is repeated a dozen times just to make sure the audience gets the point.
As noted, the folktale, the Märchen, is a ghost story, to be told on dark October nights around Halloween. The empathy of the audience is aroused by increasingly gruesome images of dismembered bodies. The audience definitely shudders, getting the creeps, but not the protagonist. Meanwhile, the audience is taken through the three stages of overcoming over-intellectualization, overcoming resistance to empathy, and recovering his full humanity in a rich emotional life.
We retell the story, emphasizing the empathic and emotional aspects.
In the first stage of recovering one’s empathy, one must descend into the hell of one’s own lack of integrity and inauthenticities to regain access to and expand one’s humanity. The dogs and cats with red-hot collars and chains are images from hell. The assignment? One has to descend into the hell of one’s empathy breakdowns, misfirings, inauthenticities, blind spots, self-deceptions, and failures, in order to break through the refiner’s fire of self-inquiry with renewed commitment to empathy, relatedness, and community. One must clean up one’s own act, restoring integrity where it is missing in one’s own actions before carrying empathy forward to others; otherwise the attempt to recover and expand empathy is like putting butter cream frosting on a mud pie. It doesn’t work.
However, even if one cleans up one’s act, acknowledges one’s blind spots and inauthenticities, and commits to empathic relatedness, the risks of failure are significant. That one is committed to relating empathically can leave one vulnerable to the risks of burn out, compassion fatigue, or emotional fragmentation.
The second night in the castle is filled with images of dismemberment. The youth’s self is vulnerable to fragmentation.

None of the dismembered body parts matter to the youth in the way they would matter to an affectively, emotionally whole person. Ghouls and living corpses surround him, but, ontologically speaking, he is the one who is an emotional zombie. Without empathy, the individual is unrelated and isolated—emotionally dead.
The guidance of the folktale is to be persistent. Set limits with courage and humor. The youth rounds the egg-shaped heads in his turning lathe, the better to play at bowling with the now-rounded heads and the dismembered legs as pins. It works. The youth’s good sense of humor and fellow feeling serve him well in relating empathically to what would otherwise be a harrowing encounter with emotional fragmentation. The integrity of the self is sustained and expanded. Everyone has fun, and the ghouls depart with the body parts at the end of the game.
On the third night, in a scene that is really quite creepy (and in which the audience, if not the youth, learns shuddering), the coffin of his dead cousin is delivered. The youth gets into bed with the cold corpse of his cousin, charitable lad that he is, in order to warm it up—and, even more uncanny, succeeds in awaking it!
The emotions are not pleasant that have long lain dormant and “dead” and are brought back to life. The person is at risk of choking on them due to their intensity. Anger and narcissistic rage are the order of the day. The awakened corpse tries to strangle the youth, but the youth overpowers it using physical strength.
The old spirit, the old man with the long, white beard, shows up for the final struggle. The simpleton youth has a breakthrough in his intelligence. He cleverly catches the old man’s beard in his vice grip and starts wailing on him.
As noted, the old spirit yields, and, delivers the treasure-hard-to-attain—the hidden gold and the hand of the princess in marriage. But, though the missing empathy ought to have been recovered by now, for rhetorical reasons, the story continues in describing the youth as still complaining about not yet having learned how to shudder. The climax is complete; the dénouement is at hand.
The individual cannot recover his empathy—or his humanity—on his own. The other is required. A relationship with the other is indispensable. The youth has raised the curse from the haunted castle and won the hand of the fair princess, and he stops trying to shudder. That is key: he finally stops trying. He stops thinking about it—over-intellectualizing. He has a passive overcoming, letting matters be. Then the other teaches him shuddering at the first available opportunity.
The wife’s chambermaid teaches him shuddering in a pun that cleverly masks the physical and sexual innuendo, throwing the cold water and flopping gold fish, causing goose bumps, a visceral experience hard to put into words.
Now the youth is finally a whole, complete human being. The absence of the ability to shudder becomes a symbol for the absence of empathy, the ability to communicate affectively. This youth had no feelings—not even fear. Thus, in this story, in contrast to Dr Know-it-all, we are dealing with bottom up, affective empathy. The absence of the emotion of fear is an extreme paradigm, a negative ideal case, of an absence of the underlying, bottom up capacity for empathy.
Taking the interpretation up a level, the youth is ontologically cut off from the community, who share emotions empathically. Life is disclosed and matters to members of the community based on their affects and emotions.
In the narrative, empathy becomes conspicuous by its absence. This absence of empathy is equivalent to the absence of the individual’s humanity. It is only after the youth undertakes a kind of training program in recovering his empathy—and his humanity—by descending into the hell of his own blind spots and inauthenticities that he is able to experience the full range of human emotions—and, ending with a laugh, shuddering.
With the assimilation of these two pre-ontological documents, we turn to the less humorous but equally significant task of defining different methods and approaches to understanding and applying empathy. The philosophy of empathy engages with diverse philosophical methods that provide access to it.
[1] Anonymous. (1804). Dr Know-it-all, The Complete Grimm’s Fairy Tales, Jacob Grimm, Wilhelm Grimm, eds., trs. Margaret Hunt and James Stern. New York: Pantheon Books, 1972/1994: 456–457; translation modified.
[2] Anonymous. (1804). “The story of the youth who set forth to learn fear,” The Complete Grimm’s Fairy Tales, Jacob Grimm, Wilhelm Grimm, eds., trs. Margaret Hunt and James Stern. New York: Pantheon Books, 1972/1994: 29–38; translation modified. This is a complete reworking of Lou Agosta. (1980). The recovery of feelings in a folktale, Journal of Religion and Health, Vol. 19, No. 4, Winter 1980: 287–297.
[3] See: R. Adolphs, D. Tranel, H. Damasio, A. Damasio. (1994). Impaired recognition of emotion in facial expressions following bilateral damage to the human amygdala, Nature. 372 (6507): 669–72. DOI: 10.1038/372669a0.
Image credit: Dr Know-it-all: Creative Commons: An old man in a top hat sitting in a wooden cart with wheels Wellcome V0020405.jpg
Image Credit: Otto Ubbelohde (artist) – Images of fragmentation: Märchen von einem, der auszog das Fürchten zu lernen (Public Domain)
(c) Lou Agosta, PhD and the Chicago Empathy Project
Review: Politics of Empathy by Anthony Clohesy
The Politics of Empathy by Anthony M. Clohesy is a compellingly original and innovative engagement with empathy in a political context.
[Anthony M. Clohesy. (2013). Politics of Empathy: Ethics, Solidarity, Recognition. Oxon, UK: Routledge. 160 pp.]
I begin by expressing my admiration and enthusiasm for Clohesy’s contribution. Encountering this straight up, occasionally understated, frequently dense, work was thrilling. For me it was a page turner, albeit in a scholarly way. I saw old things in new ways. This book changed my thinking. At the risk of a military metaphor, Clohesy’s work is like two inbound cruise missiles: the first blows off the door of conventional political thinking, the second, blows up the bunker. Not for the faint of heart.
Clohesy’s big idea is that empathy is about identity and similarity, but it is just as fundamentally about differences. Key term: empathy of differences. This provides a powerful angle on that vexing issue of empathy and ethics, which has the frustrating aspect of being a chicken and egg dilemma. Does empathy found ethics, which seems too “touchy feely”; does ethics found empathy, leaving us with the counter-intuitive sense that the “bad guys” sometimes use empathy; or do empathy and ethics develop separately, leaving us with a non-empathic ethics or a non-ethical empathy? The matter starts to spin.
Clohesy’s idea (continued): the challenging relation between ethics and empathy is that they both emerge

simultaneously in the encounter with difference – the encounter with the other individual – and the result is – politics.
I now try to motivate the discussion of this innovation of an empathy of difference and recognition from an eventual encounter with the other individual. Key term: the event of an encounter.
Speaking in the first person, when I encounter an individual who is different than I am, then I have an experience of otherness. However, every person I encounter, without exception, is different than I am, even if there are many similarities between us. The other is different. Period. And, here is the punchline, without the other individual there is no empathy. Empathy is born in otherness. Empathy is a function of otherness. Empathy emerges from and in otherness. Without the other individual there is only myself – oneself – all alone. Empathy is the one thing you cannot do all alone.
The empathy of differences emerges in encountering the other individual, who resists one’s spontaneity, initiative, and one’s action, pure and simple. This resistance creates a boundary between self and what is other. The attempt to traverse this boundary and overcome the resistance requires an expenditure of effort, force, energy. This dynamic of effort and resistance, strictly speaking, is different than violence, but resembles the “violence” of Sisyphus pushing that boulder up the hill (in the myth), only to have it slide down again.
Clohesy does not use the term “resistance” and he may not agree with it, but I find I need to get to the key role in Clohesy of “violence,” which is not standard violence. This expenditure of effort, energy, or reaction to resistance, is experienced as a kind of violence.
As I read Clohesy – and he is extremely subtle on this point – the encounter with otherness inevitably turns violent in some metaphysical and even mystical sense. Or more precisely was already violent. The encounter with otherness thus entails a struggle with otherness. Otherness shows up as resistance to my will.
Clohesy denies that he uses “violence” in the ordinary sense of the word as to kill someone: “My use of the term “violence” should not be misunderstood. It does not refer to how we kill and oppress each other [….] Rather, it refers to how the fragile interiority of our lives is constituted and sustained by power” (p. 85).
Clohesy writes: “My central claim is that empathy is important, not because it can eradicate our inherited capacity for violence and cruelty, or reconfigure the deep structural forces that inhibit a transition to a more ethical world, but because it can make us more aware of our violence and cruelty. Thinking of empathy in this way is important because it allows for the emergence of a space in which more ethical relationships between us can develop” (p. 67).
I agree and align: empathy expands our awareness. But if that is all, then we are in even more trouble than we imagine because we humans are an aggressive species, highly territorial, intermittently over- or under-sexed, now armed with weapons of mass destruction. Heavily armed. Absent an intervention, this is not going to go well – indeed it is not going well. Where to go from here?
Clohesy comes into his own with an empathy of recognition. With an empathy of difference, instead of identity politics, we get a politics of recognition. Though we are different, our interests, experiences, and aspirations as human beings are recognized. Our possibilities converge instead of conflict. Our opportunities align instead of clash. We are able to cooperate instead of obstruct one another. We are able to build instead of tear down.
Talking a walk in the other person’s shoes yields an empathy of differences. One discovers the otherness of the other. The shoes rarely fit right. One discovers where the shoe pinches – but the other’s shoe almost inevitably pinches at a different spot than it pinches one’s own foot, because the other foot is slightly different – longer or shorter than one’s own.
Clohesy traces the empathy of identity and difference (recognition) through nature, religion, and culture. He invokes and critiques “otherising”: the act of essentializing the identity of others. He cites Kathleen Taylor: we are hardwired for contamination – to experience contamination or a sense thereof from contact with the othered other (p. 8).
According to Clohesy, empathic experience of difference allows us to recognize others. This is the encounter with difference: feeling into the life of another person as culture (p. 30).
On a good day, the way we engage with “others” is sufficiently empathic to understand the reasons why their values, norms and practices are often so different from our own. Clohesy is clear that “understanding” is not confused with “condoning” or “agreeing” or “approving.” We must deploy a rigorous and critical empathy that challenges practices and values with which we have issue or divergences.
Nature brings with it an empathy of identity – essentializing differences which makes them difficult if not impossible to overcome.
With nature, the shadow of tribalism falls over politics – and empathy. The empathy of identity is ultimately that of proximity to family, tribe, local community. There is nothing wrong with that. It is excellent. We would be less than human without it. But it is ultimately derivative and incomplete without an empathy of difference.
Empathy of identity gives us communalism, which provides a strong internal empathy towards family and friends and those near and dear, but does not recognize the otherness of those remote – does not acknowledge the otherness of those not proximal (those who are remote) – they are not other – they are invisible – pre-other – we may think of them but we think of them in the way of not thinking of them
Clohesy properly cites evolutionary psychology as to how our first instinct is to favor those of our own tribe, those we see as ‘our own’ (p. 47). Yet when seen in the context of empathy, the violence of nature requires that we humans must engage with strangers in a spirit of recognition and solidarity, rather than distancing ourselves from them. Clohesy does not cite Martin Luther Kind but I do: “Learn to live together as brothers or perish together as fools.” Easier said than done.
Perhaps religion can help. Regarding transcendence, Clohesy’s argument is that we can and should recognize the importance of religion without necessarily having conventional beliefs about it. He makes good use of Karen Armstrong: Religion “works” when it is appreciated in the context of myth or when it is seen in the context of unknowing. Logos could not undo, assuage, or cure human grief or find meaning in life’s suffering. For that, people turned to mythos or myth.
What then of myths? Clohesy’s is a slim volume with limited word count, but the religious and political myths are legion – mostly as echoes and allusions. The time of the mythical violence of Hobbes’s “war of all against all” or Rousseau’s State of Nature or Rawls’ Original Position. The struggle of Hegel’s master-slave dialectic, Freud’s band of brothers murdering the tyrant father and inventing an early version of the blessed Eucharist, Cain and Abel, are one-and-all echoed mystically.
Then there is the matter of The Event. One needs an encounter with The Other to get empathy started. This encounter takes on the quality of a logical reconstruction and even mythical Event. It is like the Big Bang in cosmology. It does not make sense to ask what happened before this Event, because the before/after distinction itself did not exist prior to the Big Bang, which is when time itself emerged, time being the source of the before/after distinction. Clohesy has a lot to say about the Event in the context of empathy and politics (cosmology does NOT come up, but maybe it should).
It’s not like there is a temporal sequence at this point. The other already has always been a synchronous aspect of oneself. If there is a myth, it is that human beings are unrelated. We are always already related. Definitely.
At this point, we (and Clohesy) are in mystical or metaphysical time (as near as I can figure out). Empathy is one thing one cannot an individual cannot do all alone. One may be the creator of one’s entire universe – life is literally but a dream – until one encounters the other – then one wakes up to the reality of the resistance of the other – the otherness of the other. I would rewrite certain passages using “resistance” rather than “violence,” but I do not claim this is the truth with a capital “T.”
For many people, life is experienced as pushing a boulder up a hill at which point the boulder slides down and has to be pushed up again (think about Camus and the Myth of Sisyphus). One works all month to put food on the table for the family and pay the rent, then next month one has to start over and do it again. For people who are born rich life is easier, and yet at some point everyone has the experience of pushing that boulder up the hill.
When pushing the boulder up the hill, it is hard to empathize with the boulder. It is easy to hate the boulder. But that hatred is already a form of negative empathy with the boulder. But in a mythical context one might discover that the boulder was made by the other or is itself the ultimate other.
Though Clohesy does not explicitly say so, I believe he would agree that empathy is the foundation of community, that is, the political community. But it is an empathy of difference, not one of identity. If you go with an empathy of identity, the result is tribalism. “I get you, man, and you get me, bro, because we are [mostly] alike.” But then there are all these different tribes – Democrats, Republicans, Progressive, Conservatives, Christians, Muslims, Jews, Hindus, Buddhists, Confucians, Quakers, all 193 member nations of the United Nations – not to mention the Chicago Cubs Baseball team.
Once again, though Clohesy does not explicitly say so, tribalism itself sets in motion a dialectic whereby each individual can belong to multiple tribes with multiple identities and affiliations. Even you get enough tribes and enough overlap between tribal identities, the notion of identity starts to dissolve into a kind of melting pot of multiculturalism or ecumenical spirituality or market place of competing political ideologies. Even if the melting pot never completely melts, it can at least become a colloidal suspension – cosmopolitanism – where the identities and differences are fine-grained enough not to subvert individual diversity or the aspiration to universally shared values.
But absent such a dialectic – for example, in traditional societies or insular communities – the empathy within the communal group works well enough but breaks down at the boundaries.
Clohesy’s response to the breakdown of the empathy of identity? He asserts that the protection of culture and the recognition of difference require an account of cosmopolitanism (informed by an empathy of difference). In turn, cosmopolitanism “is able to subvert essentialist conceptions of difference … the most toxic enemy of the politics of recognition” (p. 43).
Clohesy endorses a cosmopolitanism that recognizes others as equals and opposes committing arbitrary violence against others in a context of values disclosed to us by the empathic experience of difference (p. 44). Presumably non–arbitrary violence would be a police man stopping a home invasion by the bad guys. Presumably non-arbitrary violence would align with Max Weber’s definition of the state as having a monopoly over the legitimate use of force.
The mythico-metaphysical ontological aspects of Clohesy’s contribution emerges with his innovative application of Alain Badiou’s distinction of the Event, itself perhaps inspired by Heidegger’s Vom Ereignis. “Or, to put it differently, our constitution as ethical subjects requires experience of an Event in the form of the empathic encounter with difference” (p. 92). “…[E]mpathy is important in this respect because the experience of difference it makes possible to give form to our ethical lives by allowing us to emerge as beings aware of our finitude, but also aware that we are condemned to commit violence to realize that which is impossible” (p. 93). What could be clearer or more transparent?
Since this is not a softball review, it msut be said, this is as clear as mud – and yet there is something extremely original and powerful going on here. I can make some sense out of it in terms of a rational reconstruction of the encounter of the self and other, in which the other offers resistance to the self thereby bringing the intersubjective world of conditional possibilities and impossibilities into existence.
Another word of caution: Clohesy’s is work of significant scholarship, and merely well-educated readers without an academic background may find parts of it to be a challenging read, though a valuable one. I think Clohesy has read everything – okay, almost everything, relevant to politics and empathy. An impressive accomplishment.
My most significant concern is with his use of the term “violence.” As quoted above, Clohesy does not mean “killing” – I believe he means a kind of struggle or resistance or encounter with the otherness of the other than deteriorates into the violence that creates what Hegel called the butcher bench of history.
Clohesy writes of arbitrary violence. Presumably when Cain slays Abel it is arbitrary violence, but when David slays Goliath that is nonarbitrary? When Pharaoh or King Herod slaughter the First Born that is arbitrary violence? But when Yahweh takes the first born Egyptians that is non arbitrary? How about when Burnham Wood come to Dunsinane, and McDuff kills Macbeth, the tyrant? How about when the posse chases down the John Wilkes Booth, the assassin of Abraham Lincoln, and burn down the barn in which he is hiding?
In this regard, Clohesy might have done well to deploy Hannah Arendt’s fundamental distinction between violence and power. When political power of a state or regime goes down, then out come the riot police, the tear gas, the rubber (and lead) bullets. “Power down, violence up” – Arendt’s proposal – is as predictable as night following day.
In conclusion, Clohesy asserts his use of empathy opens the articulation of an account of politics that promotes and reflects a sustainable vision of the good life. He claims that the relationship between empathy and politics can and should be understood in the context of reciprocity or as elements within a virtuous circle. Clohesy further claims that, because empathy provides use with a sense of our duties to others, it allows us to see politics as something that is enabling, necessary, noble and ethical (102).
References
Anthony M. Clohesy. (2013). Politics of Empathy: Ethics, Solidarity, Recognition. Oxon, UK: Routledge. 160 pp.
© Lou Agosta, PhD and the Chicago Empathy Project
Review: A Silvan Tomkins Handbook: Foundations for Affect Theory by Adam Frank and Elizabeth Wilson
Silvan Tomkins (1911 – 1991) is an innovative, ground-breaking interdisciplinary psychologist. Tomkins’ four volume Affect, Imagery, and Consciousness is a Mount Everest of the study of affects and the emotions. Like Mount Everest itself, Tomkins’ work is on the border of several gigantic kingdoms, extending from philosophy to psychology, neurology to evolutionary psychology, data rich empirical research to high speculation, phenomenology to an early version of critical theory, behaviorism to personality theory and psychoanalysis.
The result of the complexities and multidimensionality of Tomkins’ contributions is that his work has remained less well known, for example, than Tomkins’ student Paul Ekman, and Tomkins is regarded as hard to read, dense, difficult and even inaccessible. Until now.
A Silvan Tomkins Handbook: Foundations for Affect Theory by Adam J. Frank and Elizabeth A. Wilson (Minneapolis: University of Minnesota Press, 2020, 105 pp.) provides a sophisticated roadmap into the
complex terrain and intricacies of Tomkins’ innovative approach to the affects. Without oversimplifying and with admirable conciseness, Frank and Wilson engage with the tough issues and reliably clarify and illuminate them: the relation of Tomkins to Darwin – continuity or innovation; the philosophical deep structure of Tomkins thinking, including his PhD dissertation in philosophy on the Scottish enlightenment figure Bishop Butler; his work with W.V.O. Quine in logical empiricism and pragmatism; the debate about the affects as the bearers of propositional content; the relationship to Spinoza and the latter’s theory of desire, passion, and value; the adversarial relationship to Freud’s drive theory, while using psychoanalytically-informed listening to describe the affects in their intersubjective context; what happens to the affects in the human context of community, namely, affect control scripts.
Tomkins’ life spanned the time when the dominant design paradigms in psychology were behaviorism and psychoanalysis. As the authors, Adam J. Frank and Elizabeth A. Wilson, note, Tomkins himself underwent a seven-year psychoanalysis with Ruth Burr (p. 138), and said that it had cured him of his neurosis.
As usual, the devil and the innovations are in the details. The conventional wisdom is that a straight line exists between Darwin, Tomkins, and Ekman. Frank and Wilson demonstrate decisively that it is a best a zigzagging dotted line.
A biological dimension exists to the affects – neurological, glandular, muscular, parasympathetic, visceral, and so on. How society and community then take and elaborate, magnify, and transmute that biology are of the essence.
The difference between Darwin and Tomkins is substantial. Darwin sees the human smile (among many things) as a vestigial remnant of our canine ancestors baring their teeth to express the mixed message “I am friendly enough but also know how to be aggressive and bite” [or a sentiment to that effect]. If the smile expresses anything for Darwin, it is as a fossilized remainder of mammalian behavior, thereby making Darwin’s key argument of continuity between man and animals.
According to Frank and Wilson, while Tomkins does not contest Darwin’s finding, Tomkins’ thinking moves forward and perhaps at right angles. Tomkins endorse a “stored affect program” but does not reduce “affect complexes” to such a program (p. 35). Most authentically, Tomkins innovates an “inverse architecture” to the emotions whereby the affect of interest and excitement (“happiness”) is literally in the smile itself. Nothing is hidden. The affect lives in the smile.
Tomkins is just getting warmed up here: “the affects are also always necessarily social, conscious, facial, scripted, ideological, and interpersonal (p. 33). It is not even clear that Tomkins is a proper Darwinian: “What is evolutionarily basic for Tomkins is not fitness but rather the capacity to conjoin and disjoin and cleave” (p. 34), which provides the complexity of affects transmuted into emotions in real life social situations.
Neither Frank nor Wilson – nor Tomkins – are responsible that Darwin’s classic, innovative, ground breaking work on the emotions is deeply flawed.
Darwin’s work on the emotions took considerable pains to disagree with and refute Charles Bell’s assertion that the emotions were purposeful in a spiritual deistic sense, showing us the wisdom of the ultimate designer of the clockwork universe, as noted, the God of the deists and quasi-Unitarians. Apparently the emotions could not be both purposeful and perform the work of Darwin’s own quasi-divine first principle of adaptation, natural selection.
Though this goes momentarily beyond the confines of Frank and Wilson, the matter is of the essence. The scandal is that Darwin, after banishing purpose from the human emotions to link them with the animals, then had to fall back on the [Lamarckian] inheritance of acquired characteristics (not natural selection!) to account for the continuum between the “expression” of emotion in man and animals. Animals such as dogs and chimps were indeed expressing their emotions; but man was performing habitual behaviors continuous with the behaviors of dogs and chimps without purpose that had taken on a fossilized life of their own in man in the species homo sapiens. The scandal grows as, for Darwin, the emotions are not even expressive (in a work with that title!) – the emotions are vestigial gestures.
Tomkins may have had an appreciation of the nuances of Darwin’s position that even Darwin lacked thanks to Tomkins’ work on Bishop Butler and the other Christian and deistic divines of the Scottish Enlightenment. But Tomkins never made explicit the noted limitation or background controversy.
Meanwhile, Paul Ekman has built on the work of the giant, Tomkins, that came before him. Ekman states he spent seven years on a potentially career ending research project to map Tomkins’ example that, in effect, happiness lives in the microexpressions of the smile on the face. Until his retirement, Ekman broke out of the academy and was consulting to the FBI and other large law enforcement organizations about how to tell if the would-be suicide bomber is unwittingly expressing his contempt for the capitalist dogs by focusing on the barely conscious microexpressions of contempt that provide “tells” of a hidden affect.
Given the authors sustained discussion of Tomkins interest in computers, cybernetics, automation, science fiction accounts of biological robots in Philip K Dick, they will be interested to learn (but do not note) that a version of Ekman’s facial action coding scheme has indeed been implemented by a company called Affectiva. To their credit, Affectiva has refused to do business with totalitarian governments, but that does not prevent the latter from trying to steal or reverse engineer the algorithms. The genie is out of the bottle.
Frank and Wilson point to the speculative deep structure of Tomkins’ thinking in the work of Spinoza. The crosscurrents and parallels are abundant – including quotations that echo one another: “It is our theory of value that for human subjects value is any object of human affect. Whatever one is excited by, enjoys, fears, hates, is ashamed of, is contemptuous of or is distressed by in an object of value, positive or negative (1:329)” 9p. 76). Freud was a secret – and not so secret – admirer of Spinoza, whose therapeutic project gives aid and comfort to all those fellow travelers seeking to extend the bounds of self-knowledge in transmuting affects into action, not mere cognitions.
Frank and Wilson consistently push back against the assertions of Ruth Leys on the rise of affect. Now one should never dismiss Leys’ penetrating and incisive commentary. If one is going to hunt and look to bring down big game, it makes sense to go after Ekman and Tomkins. No one is interested in refuting, for example, the author of this review, because few have heard of him (i.e., me). No glory there.
Frank and Wilson defend Tomkins against the assertion that he initiates the anti-internationalist movement (which, presumably, accelerates with Ekman). I summarize the defense: because affects are born in an unintentional (“non propositional”) context does not mean that they remain there.
Building on Tomkins’s account of affects, his theory of imagery and consciousness recruits significant propositional content in a powerful and therapeutically informed context of scripts. Frank and Wilson perform an admirable job of explaining the non-intuitive subtleties of affect control scripts. I provide an example:
Consider, for example, the section titled “Production of a Total Affect-Shame Bind by Apparently Innocuous and Well-Intentioned Parental Action” (2: 228), which begins, “Our hero is a child who is destined to have every affect totally bound by shame.” Over two pages, Tomkins sketches an excruciating set of hypothetical scenes that take place around a 1950 American dinner table in which a child is shamed by his parents for expressing each of the primary affects: “Don’ ever make that face again at the table – it’s disgusting” (2: 229), “Oh, Robert, you’d think you hadn’t eaten in a week, really!” (2: 229), “Robert, where are your manners? Sit up (2:229 – 30), “Robert, you could be a little more attentive, you don’t have to sit there like bump on a log. Say something” (2:230).”
This does indeed set up a script – an affect “out of control” script. As I read them, each of these is a micro-narrative – a script – in which a breakdown in empathy occurs, inflicting micro-aggressions in a context of affect amplification, psychological magnification, and a script for ongoing emotional disequilibrium. I hasten to add that the word “empathy” does not occur in Tomkins, but it lives there nonetheless in this and many other dramatic sections.
To tie together nonintentional affects with the propositional content of affect control scripts, an account of emergent processes, properties, and relationships is required. Although elements of such an account are to be found in the systems thinking, and feedback mechanisms that inspired Tomkins in the works of Norbert Wiener and the early cyberneticists, I do not believe a complete or satisfying answer is to be found there – or, for that matter, in any philosophy of science or design paradigm. This is not a criticism of Tomkins or the fine work of Frank/Wilson; but points to one of the great intellectual challenges of our time – a coherent account of emergent properties in context.
Another one of the take-aways from my reading of Frank and Wilson is that some of the best work being done in psychoanalytically-oriented circles is occurring in comparative literature, gender studies, and the like. While not narrowly psychoanalytic, this work is an example of that latter.
Psychoanalysis as a clinical practice continues to succumb to self-inflicted wounds of arrogance, elitism, cost, scheduling, and intermittent dogmatism. Today’s analysts are simply practicing cognitive behavioral therapy (CBT) and asking clients about their dreams between homework assignments.
Psychiatry does allow for some simple affects as anxiety (fear), low spirits (depression), high spirits (mania), or anger; but, notwithstanding Panksepp or LeDoux, psychiatry lacks a sufficiently complex or nuanced account of the affects. “My amygdala made me do it” may indeed be true in specific instances of traumatic activation or “being triggered,” but it does not clarify the rich affective detail, nuances, human blind spots, struggle and effort in people’s lives, relationships, communities, and, ultimately, it demonstrates you’ve just got the wrong philosophy of science. A better one based in systems theory that allows for the emergent properties of the affects in their richness and complexity in biological and sociopsychological context is brought forth in the course of Tomkins’ contribution and this guide to it.
(c) Lou Agosta, PhD and the Chicago Empathy Project


