Home » a rigorous and critical empathy (Page 2)
Category Archives: a rigorous and critical empathy
My empathy lessons – in the beginning
My empathy lessons started when I was about four years old. My Mom would tell me bedtime stories. Right before bed, she would weave a narrative out of the significant events of a day in the life of an “on the go,” four-year-old boy. She would make a whole out of my experiences by telling me a story about this imaginary boy—his name was “Doodle Bug.”
For example, in a favorite story, Doodle Bug would ride his tricycle, and he would go through the park to visit the Indian Chief. He would make a treaty with the Chief. Then he would ride to the bakery. At the bakery he would sample a selection of cookies and cakes. Always the talented young man, Doodle Bug would “stand on his noodle for apple strudel.”
In the moment, as a four-year-old, this was hilariously funny. I had no idea what apple strudel was, and when I found out a little later, I did not particularly like it. To me, the suspense in the story was palpable. Would the Indian Chief (surely a father figure) be open to a treaty or would hostilities break out as in the cowboy movies that were popular at the time? The rhyme with which the story ended released the suspense in the narrative. It was funny, provoking a laugh, and it brought the story to a satisfying, dramatic close, clearing the way for a soothing transition to sleep.
This was my Mom’s empathic response to a busy, on the go, growing boy. I acknowledge her for it; and my emotional life and future were richer thanks to her. She took my experiences on a given day, wove them into a nuanced narrative, and gave them back to me as a bedtime story. I recognized the experiences as my own. I recognized that she got who I was for her. Brilliant. I was mesmerized. I was spell bound. I was soothed. I was comforted. I was stimulated (but not too much). This was the empathic moment.
Mom was tuning down the day as she was tuning up the empathy for me. She was calming down the day as she was also tuning up my empathy for myself. I was empathically transitioned from a busy day to a state of restfulness and readiness for sleep without the anxieties that can sometimes accompany a child at bedtime.
This was not to say that my childhood was all rainbows and balloons. There were plenty of upsets, too. It is not that I never had anxieties, but, in this case, they were over shadowed by the good stuff. This is a fine example of things going just right for a change; and how empathic responsiveness made a positive difference in one young boy’s life.
Story time—narrative—gives back to the other person his own experience in a way that he can recognize and integrate it. In this case, Mom wove a narrative out of the events of the day, helping her child integrate his experiences. When the other person recognizes his own experience in the story, as I did, then the empathic loop is complete. I got empathy at the end of the day.
Note that, in this and similar situations, a lot of work has to occur prior to the story. The narrator (Mom, in this case) must have access to the events being woven into the story. Her empathic receptivity, empathic understanding, and empathic interpretation were activated and engaged. I hasten to add that the distinction “empathy” was not made explicit. This was just Mom being Mom—a parent doing here job and getting it just right.
Therefore, advice to parents: if you want to expand your empathy with your child, and your child’s empathy for her- or himself, have a bed time story. Bring the day to a close in an orderly way. If you can make up a story, so much the better. But not everyone is a natural born storyteller, as my Mom seems to have been. If you want to read a story, that is good, too. Pick something that you think will resonate with the child, or let the child decide what she or he wants. In the case of my daughter, after awhile, I read her whatever she requested. The genius of the “out there” and wholesome sense of humor of Richard Scarry for children of tender age also deserves honorable mention. The point is to have that time together—that, too, is the empathic moment.
Then when tough times occurred—I do not go into the details since my now grown-up daughter will read this—emerging adults learning how to handle things (and sometimes mishandling things), I went down to dorm and said, “Okay, get your stuff—you are coming home for awhile.” And, low and behold, she listened! She knew I was concerned about her and had her well-being in mind and she listened; and then she got a job for awhile and went back to school a year later. Now flourishing and working on flourishing in ways that were not visible at the time, this is not a fairy tale ending, but is perhaps good enough in this world of helicopter parents, absent parents, and failures to launch.
For those who would like a further inquiry into how empathy is defined – storytelling shows up in many contexts, but when it builds an empathic relationship, storytelling falls under “empathic responsiveness” –
Empathy consists of four parts or dimensions, which, in turn, form the integral whole of authentic relatedness between individuals in community. These four dimensions are receptivity, understanding, interpretation, and responsiveness:
- Empathic receptivity is the dimension of empathy that consists in being open to the other person’s feelings and experiences. It often presents as a vicarious experience.
- Empathic understanding is the dimension of empathy that engages the other person as possibility in his or her humanity. It often presents as possibilities of accomplishment, fulfillment, flourishing.
- Empathic interpretation is the dimension of empathy that takes a walk “in the other’s shoes,” the part corresponding to the folk definition of empathy. It often presents as shifts in perspective or points of view.
- Empathic responsiveness is that dimension of empathy that provides a gracious and generous listening as the source of a response that offers the other person her or his own experience back in a gesture, statement, story, or narrative. It often presents as a short narrative (“micro narrative”) or story, also called “rhetorical empathy.”
These four dimensions of a rigorous and critical empathy go around, but not exactly in a circle. One does not end up exactly where one started; one makes progress—progress up the winding and twisting hairpin curves of the mountain of human understanding. One goes “round the mountain,” ending up at the same coordinates at which one started, but higher up the mountain. Different perspectives open up as one goes up.
Those in the empathic relationship have advanced upward, coming back to where they started, but at a higher level, forming an upward spiral, round the mountain of empathic understanding of other human beings. (See Figure 1.)
Figure 1: How empathy works: The four dimensions of empathy
One can start at any point with any one of these dimensions and, as noted, go “round the mountain,” engaging the other three dimensions, forming the integrated whole that we call “empathy.” One has a different perspective on the relationship, one’s own contribution to it, and the other person’s role. One key empathy lesson that drives this work forward and gets repeated at important points is: the four dimensions of empathy are a coherent whole. All four dimensions of empathy (empathic receptivity, empathic understanding, empathic interpretation, and empathic responsiveness) link to one another in a round trip extending from receptivity to understanding, from understanding to interpretation, from interpretation to response, and back. One can start anywhere in the cycle, and go around covering all the bases and end up back with the distinction with which one started, albeit at a “higher” level. You start with empathy and end up with empathy, expanded and (to shift the directional metaphor) “deepened” empathy in relating to the other person and to the community made up of other persons.
References
This post is an except from –
Lou Agosta. (2018). Empathy Lessons. Chicago: Two Pears Press: pp. 38 – 42.
(c) Lou Agosta, PhD and the Chicago Empathy Project
Summer Reading: The Song of Our Scars by Haider Warraich
I have been catching up on my summer reading: Haider Warraich. (2023). The Song of Our Scars: The Untold Story of Pain. New York: Basic Books, 309 pp.
Haider Warraich, MD, has provided an account of our relationship with pain and suffering that is a “physician heal thyself” moment and narrative. Warraich’s work is a powerful combination memoire and biological-clinical briefing on the distinction between acute and chronic pain. Now an assistant professor at Harvard Medical School, the author experienced a life altering back injury while he was in medical school. Suffice to say, the results were an entire encyclopedia of pains, extending from acute to chronic and back, and providing the reader with a compelling narrative of what medical science does not know about pain. Warraich has a way with words and catchy phrases. For example, regarding pain, “The human brain is not just staffing the ticketing booth as the [pain] circus – it is the ringleader” (p. 10). Just so.
Warraich argues: “To course-correct our approach to pain, we need to change the story of chronic pain – pushing back on the voices attempting to convince us all pain is catastrophic and life threatening and needs immediate attention over everything else right now” (p. 253). And yet the good doctor acknowledges that pain puts the person in pain in prison (p. 78). Chronic pain mirrors incarceration (p. 78); and, as for acute pain, the house is on fire and the patient is in it. Summon emergency services!? Elaine Scarry’s The Body in Pain (pp. 232 – 233) is quoted approvingly as additional reading demonstrating that pain presents as requiring urgent attention. Pain resists language, and, when inflicted, for example, in torture, can destroy one’s humanity and integrity and world, requiring long, arduous, and doubtful recovery.
Warraich provides a series of engaging briefings on aspects of pain. The reader gets three basic distinctions differentiating: acute from chronic pain; pain as such versus painful emotions such as fear (e.g., pp. 54, 65), which this reviewer would gloss as “suffering”; and pain in the context of the relationship between mind and body.
Acute pain is exemplified by such experiences as an appendicitis, a broken bone, closing the car door on one’s finger, or dropping a brick on one’s toe. Ouch! In contrast, chronic pain is morning body ache and other intermittent and recurring aches, cramping from irritable bowel syndrome, osteoarthritis, hard-to-describe headaches, or the consequences of multiple back surgeries to the spine. Chronic stress – the boss is a bully, the kids are misbehaving, the spouse is having a midlife crisis,the commute back to the office is unavoidable, the toilet is clogged – results in chronic pain (p. 177). “When people become trapped in the clutches of chronic pain and chronic stress, their lives become engulfed in an eternal, inextinguishable fire – a fire as ferocious as the one that drives the hunger for profit that fuels many modern pharmaceutical giants” (p. 179). Thanks to neuro-plasticity (a key distinction further defined below), chronic pain reorganizes the nervous system. The body expresses the imbalance, the dis-equilibrium, of the mind and its emotions (the latter, admittedly, not distinctions covered in medical school in any detail). Chronic pain stops being a symptom of an injury and it takes on a life of its own, presenting as if the pain were a disease in itself instead of a signal of an underlying or related bodily injury. Chronic pain leads to suffering, a term that Warraich mentions but does not explicitly elaborate. For example, if pain is the dentist hitting an exposed nerve, suffering is being in the waiting room anticipating the dentist hitting the nerve.
According to Warraich, medicine is very good at anesthetizing the mammalian nervous system against such acute pain, but the use of the same anesthetics and analgesics against suffering is a deal with the devil. It might work in the short term; but be sure to read the fine print. The road to hell is paved with such agreements, which, it turns out, is a redescription of the opioid epidemic. In the following, Warraich writes “pain”, but it would be more accurate to say he means “suffering”: “The confluence of advances in medicine and a barrage of pharmaceutical companies marketing directing to doctors and patients birth a movement that deemed suffering unacceptable. As spiritual voids gaped inside those economically left behind and loneliness became a way of life, people in pain [i.e., suffering] kept being sent exclusively to doctors’ offices and pharmacies [for opioids to numb the pain]” (p.147). Loneliness is indeed painful, and poverty is definitely bad for one’s health, but not in the same way as a toothache or appendicitis – loneliness and poverty are chronic and make a person cry real tears of frustration, isolation, neglect, and anger. Yet the suffering is not localized like a toothache or peripheral injury, but seems to pervade the head and chest, calling forward a sense of being burdened by something imponderable and diffuse throughout one’s upper body. In chronic pain and the suffering brought forth by chronic pain, instead of the injured organism telling the brain of the peripheral injury in the limb by means of a pain signal upward to the brain, the brain (or, to be exact, the thoughts in it) are sending the signal in the other direction – downward – telling the organism to hurt. This may be specific, if there is a specific injury able to express the suffering, but more likely the pain points are diffuse and mobile – hard to define lower back pain (e.g., Warraich’s injuries), headaches, irritable bowel syndrome, autoimmune disorders. In short, acute pain is the organism telling the brain it (the skin or peripheral limb) is hurting; whereas chronic pain is the brain telling the organism it is hurting. However, the message is highly susceptible of distortion. In some ways, chronic pain can become the memory of pain, which may or may not indicate a current injury. Chronic pain can become the fear of pain itself, expanding into pain in the here and now. In short, opioids are effective in treating acute pain but are ineffective and harmful – I would say “a deal with the devil” – in treating chronic pain (p. 174).
The poster child that not all pains are created equal is phantom limb pain. Documented as early as the American Civil War by Silas Weir Mitchell, individuals who had undergone amputation, felt the nonexistent, missing limb to itch or cramp or hurt. The individuals experienced the nonexistent tendons of the missing limb as cramping and even awakening the person from the most profound sleep due to pain (pp. 110 – 111).
Fast forward to modern times and Ron Melzack’s gate control theory of pain marshals such phantom limb pain as compelling evidence that the nervous system contains a map of the body and its pains point, which map has not yet been updated to reflect the absence of the lost limb. In effect, the brain is telling the individual that his limb is hurting using an obsolete map of the body – the memory of pain. Thus, the pain is in one’s head, but not in the sense that the pain is unreal or merely imaginary. The pain is real – as real as the brain that is indeed in one’s head and signaling (“telling”) one that one is in pain.
One question that has not been much asked is whether it is possible to have something similar to phantom limb pain even though the person still has the limb functionally attached to the body. For example, the high school football player who needs the football scholarship to go to college because he is weak academically but actually hates football. He really incurs a painful soft tissue sports injury, which gets elaborated emotionally and psychologically, leaving him on crutches for far-too-long and both physically and symbolically unable to move forward in his life. Thus, due to the inherent delays in neuroplasticity – the update to the map is not instantaneous and one does not have new experiences with a nonexistent limb – pain takes on a life of its own. That is the experience of chronic pain – pain has a life of its own – pain becomes the dis-ease (literally), not the symptom. What then is the treatment, doctor?
Warraich radicalizes the issue of pain that takes on a life of its own before suggesting a solution. After providing a short history of opium and morphine and opioids, culminating “in the most prestigious medical school on earth, from the best teachers and physicians, we [medical students] were unknowingly taught meticulously designed lies” (p. 185), that is, prescribe opioids for chronic pain. The reader wonders, where do we go from here? To be sure opioids have a role in hospice care and the week after surgery, but one thing is for certain, the way forward does not consist in prescribing opioids for chronic pain.
After reviewing numerous approaches to integrated pain management extending from cognitive behavioral therapy and acceptance and commitment therapy (ACT) to valium, cannabis and Ketamine – and calling out hypnosis (hypnotherapy) as a greatly undervalued approach (no exteranl chemicals are required, but the issue of susceptibility to hypnotic suggestibility is fraught) – Dr Warraich recovers from his own life changing back injury in a truly “physician heal thyself” moment thanks to dedicated PT, physical therapy (p. 238). If this seems stunningly anti-climactic, it is boring enough to have the ring of truth earned in the college of hard knocks, but it is a personal solution (and I do so like a happy ending!), not the resolution of the double bind in which the entire medical profession finds itself (pp. 188 – 189). The way forward for the community as a whole requires a different, though modest, proposal.
Let us allow Dr Warraich to speak for himself: “I have come to believe a good doctor has an almost magical quality to feel what their patients feels – to see how they view the world, understand where they have been and what they’ve have seen all in an instant – as well as the knowledge and expertise to respond ethically to what they see from the other side. This superpower has a name: empathy” (p. 238). Never underestimate the power of a good listening. “’Mental distress may be perhaps the most intractable pain of all,’ she [Cicely Sanders] wrote, and the answer to it was not always more drugs, because for some ‘the greatest need is for a listener’” (p. 159).
Putting pain in the context of the relationship between soul and body, the body in pain expresses the suffering of the soul. While psychiatry and neurology do not even believe in the soul, they do begrudgingly allow that there is such a thing as “mental status,” which, for example, can be compromised by the hormonal imbalance of puberty, existential anxiety, jet lag, alcohol, delirium, or other insults to the organism such as blunt trauma, which, in turn, implies a conscious mind to have such a mental status. Here’s the issue: humans are neurons “all the way down,” but then the neurons start to generate consciousness – consciousness generates meaning – meaning generates language and relatedness, language and relatedness generates community, culture, art, literature, science, and humanity. However, there are numerous details that need to be filled in here, which are still the target of inquiry and ongoing research, and you won’t learn or be allowed to study them in medical school. I hasten to add that if you are experiencing a compromised mental status due to delirium, don’t call a hippie or professor of comparative literature – you need a medical doctor!
Notwithstanding my whole-hearted endorsement of Dr Warraich’s contribution – get multiple copies of this book and give it to your friends to read – this is not a softball review. Three criticisms come to mind.
First, Warraich rightly criticizes Rene Descartes’ (1596 – 1650) abstraction of the mind (including consciousness and consciousness of pain) from the body. Having divided the unity of the human being into two parts, mind (soul) and body, Descartes then needed a way to explain the communication between them. The mind obviously does not direct the body the way the pilot of a boat steers the craft. Absent neuro-pathology, the mind and the body are a near perfect unity. The body is the perfect servant of the mind – it prepares a cup of tea without my having to communicate the desire as if to a separate entity. It just knows and starts boiling the water. Descartes solution was to propose the pineal gland as the seat of the soul in the body. Warraich does Descartes one better by developing an entire narrative about the brain’s posterior insular cortex and anterior insula, identifying a novel kind of neuron, a von Economo neuron (p 63), from which pain emerges as an emotion generated by a physical sensation. An ingenious solution, which, however, is still a category mistake. What is missing – and here it is not Warraich’s issue but a general shortcoming of philosophy of science – is an account of emergent properties such as, for example, how mental states come forth from physical processes and, just as importantly, how mental states cause physical ones (as when one literally worries oneself sick).
Second, as regards the personal parts of the author’s narrative, pick a story and stick to it. The personal narrative starts out that the potentially life changing back injury is described as tissue damage (p. 5) – the painful consequences of which should never be underestimated. But by page 91 this is redescribed as a “broken back.” Literally? The value here is in describing how the patient’s relationship to pain influences his life and how Warriach has to transform his relationship to pain in order to recover his life as a medical doctor and his contribution to healing. Of course, one could have both tissue damage and a broken back. Here highly recommended reading, in comparison to which Warraich is a modest contribution, is Arthur Kleinman’s The Illness Narratives. Stories about how chronic pain transforms one’s life, including (for example) how repeated surgeries result in a “failed back” (which technically is different than a “broken back”). Such narratives are bound to give the reader pause that medical science (or even comparative literature) understands the relation between mind and body.
Finally, regarding the magical quality of empathy, I am a strong advocate of empathy, having published extensively on its applications. Never underestimate the power of empathy, and Warraich properly calls out the “empathy gap” in medicine (p. 244). But Warraich gives empathy a bad name in that he leaves empathy vulnerable to the critique that the above-cited magical power of empathy leads to compassion fatigue, empathic distress, and burn out. It can and does. This requires treatment too. Human beings are a complex species. They can be kind, generous, and empathic; but, as painfully demonstrated by the opioid epidemic, they can also be greedy, grasping, aggressive, territorial, bullying, experts in know-it-all-ism that obstructs listening, and exploiters of politics in the negative sense. The short empathy training is to drive out all these negatives, and empathy naturally and spontaneously comes forth. People (i.e., doctors) want to be empathic and will be so if given half a chance. The challenge is that the healing professions are constantly exposed to pain, suffering, trauma, and patients who can be difficult and unempathic precisely because they are in pain – or because they were difficult people prior to getting sick or hurt. A rigorous and critical empathy knows it can be wrong, breakdown, or misfire, so such an empathy also knows it can be validated. This reviewer believes Warraich’s compelling narrative may usefully have begun where it ends – with empathy and how empathy made a difference in his recovery and his daily life in the world of corporate medicine and at the Veteran’s Administration (VA). The VA has been criticized – “taken heat” – for not addressing post-traumatic stress disorder (PTSD) until it is dismissed and returns as substance abuse, but, based on Warriaich’s reports (p. 248), the VA is doing breakthrough work in integrated pain management, meditation and hypnotherapy, ACT, reduction in prescribing opioids, and they may become a model for other providers. Dr Warraich’s matriculation in the college of hard knocks of chronic back pain gives him standing to elaborate such an empathic approach, and perhaps he will do so in a follow up publication.
Additional Reading
Lou Agosta. (2018). Empathy Lessons. Chicago: Two Pairs Press.
Arthur Kleinman. (1988). The Illness Narratives. New York: Basic Books.
Elaine Scarry. (1985). The Body in Pain. Oxford: Oxford University Press.
(c) Lou Agosta, PhD, and the Chicago Empathy Project
Protected: In the beginning was the word – empathy!
Subscribe to continue reading
Subscribe to get access to the rest of this post and other subscriber-only content.
Top Ten Empathy Trends for 2023
Empathy is a practice and priority, not a mere psychological mechanism. Practicing empathy is a way of being in the world, creating a safe space of openness, acceptance and toleration. In the face of a contagion of Omicron, we need a contagion of empathy. Empathy is contagious. This is a condition you actually want to share with someone else, especially someone who seems to need some empathy – all the while being clear to set firm boundaries against bullying, delusional thinking, and compassion fatigue. Keep in mind this list is a top ten “count down,” so if you want to know what is #1, fast forward to the bottom.
Here are my choices and predictions for the top ten trends in empathy for the year 2023.
10 – Empathy for the jurors in the trial of the century. The prediction is that Mr T will stick to his story – “we was robbed” – even after he is indicated, believing there is no such thing as bad publicity. The prospective defendant is innocent until proven guilty and so on. However, it is noteable that a former-NSA analyst was sentenced to nine years in prison in July 2019 for hoarding official documents [https://www.nextgov.com/cybersecurity/2019/07/ex-nsa-contractor-serve-9-years-hoarding-classified-information/158564/]. This seems open and shut. Nevertheless, this trend is about the jurors and not the defendant. This promises to be a long, headline-grabbing trial, and the jury will have to be sequestered, cut off from news, and, subjected to a lot of legal jargon. Being without Facebook and Twitter and other
is. While the challenges of finding an unbiased jury are not trivial, all that is needed for a fair trial are twelve people who are willing to set aside their opinions and look at the facts from the point of view of the law as defined for them by the presiding judge. That sounds like creating a space for critical thinking and taking multiple points of view, the latter the folk definition of empathy.
9 – Empathy in time of war becomes Red Team not kindness. All the empathy in the world is not going to help anyone if one country invades another with a list of intellectuals, business people, and politicians to be arrested and killed. That noted, the need for helping, compassion, and good works of all kinds is still on the critical path to building a better world. Yet in time of war or threat of war, the power of empathy consists in putting oneself in the shoes of the opponent, thinking like the opponent, and thereby anticipating and thwarting the opponent’s moves. Putting oneself in the opponent’s shoes requires taking off one’s own shoes first. Never underestimate the power of empathy – never – yet empathy does not work very well with psychopaths, bullies, totalitarian dictators, and the criminally insane. Many of these individuals will take the affective, bottom up empathy and use it against you. Therefore, empathic engagement must be limited to cognitive empathy – use critical thinking to try to figure out what the Other is thinking and feeling in order to intervene in a way that is useful according the standards of a humane community.
8 – Elon “44 billion up in smoke” Musk gets empathy for his employees, customers, and stakeholders. And if you believe prediction, then I have a bridge in Brooklyn that I would like to sell to you. The empathic truth of this admittedly cynical prediction is that many of the things that make a person good at business make him or her relatively poor empathizers. Business leaders lose contact with what clients and consumers are experiencing as the leaders get entangled in innovating the technologies in new products and services, solving legal issues, reacting to the competition, or implementing the software required to sustain operations. Yet empathy is the ultimate Capitalist Tool. Empathy is on the critical path for serving customers, segmenting markets, positioning products (and substitutes), taking the perspective of the competition [not exactly empathy but close enough?], building teams and being a leader who actually has followers. Saying that the purpose of business is to make money is like saying the purpose of life is to breathe. Definitely do not stop breathing. The purpose of business is to deliver value and satisfaction to customers. Then the revenue shows up. When the ontology of empathy exposes it as the foundation of community, then expanding empathy becomes nearly synonymous with expanding business. For example, building customer communities, building stakeholder communities, team building, are the basis for brand loyalty, employee commitment, and sustained or growing market share. Can revenue be far behind? Sometimes leaders don’t need more data, we need expanded empathy, though ultimately both are on the path to satisfied buyers, employees, and stakeholders. “CEO” no longer means “Chief Executive Officer,” but “Chief Empathy Officer.” This time one can hear the groans—from the executive suite, not the cubicles.:
Listen on Spotify: https://open.spotify.com/show/6nngUdemxAnCd2B2wfw6Q6 Empathy is one of those things that are hard to delegate. This role shows up like another job responsibility with which the CEO of the organization is tasked—along with everything else that she already has to do. As if she did not already have enough alligators snapping at various parts of her anatomy, one has to be nice about it, too? But of course empathy is not niceness, though it is not about being un-nice. It is about knowing what others are experiencing, because one has a vicarious experience and then processing that further to expand boundaries and exercise leadership.
7 – Etiquette Gurus and celebrity life coaches go back to school to learn empathy. The latest poster child for this trend is Sara Jane Ho, who reportedly broke up with her boyfriend of four years over text, and rationalizes it with a meme about context, in which the context sounded like she was busy making a Netflix show. This is right up there with trend #8, getting fired by a Twitter tweet. The context, according to the author of the article, Maureen O’Connor, was that Ms Ho’s eyes were getting puffy from crying, and she would not “look good” on her Netflix show. Empathy is a high bar and one does not get there every day. If Ms Ho’s resume is to be believed, she is a graduate of Phillips Exeter Academy, Georgetown, Harvard (attended), and now a Netflix sensation. One speculates that she is a survivor of a Tiger Mom or Bootcamp Dad (or both), and may herself benefit from getting a good listening at the side of a committed mentor. Based on the review of Ms Ho’s project by Maureen O’Connor [ https://www.nytimes.com/2023/01/02/style/sara-jane-ho-mind-your-matters.html], she (Ms Ho) exemplifies the kind of etiquette which is a disguised application of sadism, hostility, aggression, and one-upmanship. While I do not know the details and maybe I am missing the humor, but so far, all these people are easy to dislike. You go to take off your coat and you can’t because there is a knife in your back. There is nothing wrong – but something is definitely missing – empathy.
6 – Empathy is a practice not a mere psychological mechanism. Empathy is the practice of authentically relating to the other person. The practice of empathy is a way of being – being with and in relation with others. Many of the misunderstandings of empathy – especially in the form of compassion, pity, emotional contagion – can be traced to treating the practice of empathy merely as a psychological mechanism. There is nothing wrong with this as such. However, what gets missed is the relational quality of empathy. Drive out bullying, hostility, aggression, bad language, and empathy naturally comes forth. People want to be empathic if given half a chance.
5 – Empathy expands for the True Believer, but not agreement with the conspiracy or delusion. The criteria for identifying the True Believer is he or she doubles down. When the space does not arrive from Alpha Centauri – or your candidate does not win – the True Believer does not say, “I might have been mistaken and maybe I need to look at my assumptions or inquire into other scenarios.” The True Believer doubles down – “We was robbed!” “We will catch the next space ship!” It does no good – none – to disagree with the True Believer or to argue or reason, because the delusion or conspiracy theory is holding together the True Believer’s personality. To give up the delusion would be to give up the personality, to risk the disintegration of who the person is. What to do about it? Teach critical thinking. Both empathy and critical thinking create a space of acceptance and tolerance in the context of which the power of the delusion starts to shrink. More on this in the next trend.
4 – Empathy and critical thinking form an alliance. It is a bold statement of the obvious that the ongoing breakdown in community standards bodes ill for a cultural and political and public conversation context in which disputants engage in near delusional disagreement on basic quantitative facts such as the rules of etiquette, basic science such as the biology of vaccinations, gender distinction (or not), the basic results of elections, and so on. Though it is not a quick solution, it is hard to think of a better one: teach skills in critical thinking such as assessing facts against sources, evaluating the reliability of sources, reporters, informants, and so on, against prior performance, checking validity and logic of arguments, and engaging enlarged thinking in taking the point of view of the other person, especially if the person (or group) disagrees with one. (See Jonathan Haber, (2020), Critical Thinking. Cambridge, MA: The MIT Press.) Taking different points of view, of course, is the basic folk definition of empathy. But do not forget to take off one’s own shoes before trying on the other’s or one will get projection, not empathy.
3 – Translation replaces projection as the underlying model for empathy. “Translation” as in translating between languages or between different artistic media or different signaling systems. In short, psychologism – psychology in the negative sense – is replaced by the linguistic speech act of translating the other person’s experience into one’s own and then giving it back (empathically) to the other. This paradigm of empathy as translation is arguably at the same level of generality as empathy as projection, but remained undeveloped until the rise of hermeneutics along a separate trajectory. The modern innovators of interpersonal empathy such as Carl Rogers (1902–1987) might be read as leap-frogging back to the original sense of entering the other’s world in order to translate it into the first person, subject’s own terms. The translation model of empathy (credited to Johann Herder (1744 – 1803) of whom one rarely hears today) also fits well with what Gordon Allport (1897–1967) and Kenneth Clark (1903–1983) were doing in arraying empathy against racism and prejudice in expanding the boundaries of community by empathically translating between them. An entire possible alternate history of empathy, as yet unwritten, opens up at this point – empathy as translation between persons.
2 – Empathy for the Amazon rain forest grows and reaches a critical mass, but will its critical mass be enough or too late to overtake the “critical mass” of green house gases. The challenge is that global warming does not live like an actual possibility for most people, who cannot imagine such an outcome – for example, just as in December 2019 no one could envision the 2020 global pandemic. Empathy is oxygen for the soul. If the human psyche does not get empathy, it suffocates. Climate changes makes this metaphor actual. If humanity does not drown as the massive Greenland and Antarctic ice sheaths slide into the oceans, humans will suffocate as the levels of green house gases and heat overwhelm temperate habitats. There is no Planet B.Empathy is a bridge: The bridge between the gridlocked present and a seemingly impossible-to-imagine future is empathy. The empathic moment is an act of imagination. That is the interesting thing about empathy. It may seem like a dream; but the dream lives. It is inclusive. Lots more work needs to be done on this connection. For purposes of this list of predictions, this “shout out” will have to suffice. For specific actionable recommendations, see David Attenborough’s A Life on Our Planet, now streaming on Netflix: https://www.netflix.com/title/80216393
2a – Vaccine deniers get empathy and say: “Oh, I wish I were already experiencing the minor side effects of the latest booster shot instead of systemic organ breakdown!” People get the latest booster against Covid, parents get their children the measles and polio and other shots the children need for school, which gets into people’s arms at an accelerating rate. Vaccine deniers get empathy and say: “Oh, I wish I were already experiencing the minor side effects of the latest booster shot instead of systemic organ breakdown!” Biological science continues to produce small, medium, and large “miracles,” even as basic health care services for citizen’s struggle. People become medical doctors and nurses and enter the healthcare field because they want to make a difference. They experience an empathic calling to intervene to reduce the pain and suffering in the world. Then these same people get caught up in the faceless, unempathic bureaucracy of a healthcare system where capitation means doctors have to see an unworkable number of patients a day – four an hour for eight hours. Using empathy and medical ethics, the doctors push back saying: “I am required by medical ethics to spend as much time with the patient as is needed to get the patient the medical treatment they require – and are entitled to be paid for it.
2b – Men lead from empathy in the struggle against domestic violence (DV). When powerful men such as Bezos, Musk, Ellison, Gates, Biden, Milley, clean up their failures of leadership and take action saying “Violence against women anywhere – home or work or anywhere – is unacceptable and here are the resources for intervention,” then a breakthrough will occur. Men will find their voice and speak out even more loudly and provide leadership against domestic violence to those of their own gender who just do not get it.
While women have provided the leadership and will continue to do so, powerful men must step up and provide guidance to their fellows about proper boundaries and respect for them in relationships. This is ongoing. What is new: powerful men step up and speak out and provide leadership among men in establishing respect for boundaries in creating communication, affection, and affinity.
For data- and empathy-based innovations that have occurred in the past year in the fight against domestic violence see No Visible Bruises: What We Don’t Know About Domestic Violence Can Kill Us, New York: Bloomsbury Publishing, 2019. Some sixty percent of domestic violence (DV) victims are strangled at some point during an abusive relationship (p. 65): Big red flag that the perpetrator is escalating in the direction of homicide/Femicide.
Empathy almost always has its uses when tuned to the specific circumstances. Yet empathy is unhelpful in dealing with sociopaths, psychopaths, and [most] bullies. They take whatever empathy you give them and use it the better to manipulate. Top down, cognitive empathy – yes – to understand whether they are a threat and are going to escalate; but therapeutic empathy – “i get you, bro” – is often counter productive. What is productive? Set limits. Set firm boundaries – and enforce them.
Turns out that only some 15% of the victims in one study had injuries visible enough to photograph for the police report (p. 66). Most strangulation injuries are internal – hence, the title. Good news/bad news: The Fatality Review Board is an idea that is getting attention with law enforcement and the local states attorney function. More progress and action is needed in this area.
(1) People stop saying, “I just don’t get empathy” and commit to the practice of empathy. Empathy is a practice and, like all practices, it can be improved by training. Remove the obstacles to empathy such as cynicism and bullying—and empathy comes forth. Remove the resistances to empathy and empathy naturally and spontaneously expands. Most people are naturally empathic.
The one-minute empathy training is trending: Eliminate the obstacles to empathy and a space of acceptance and toleration spontaneously emerges.
Most people do not sufficiently appreciate this: people are born with a deep and natural capacity for empathy, but they are also born needing to learn manners, respect for boundaries, and toilet training. Put the mess in the designated place or the community suffers from diseases. People also need to learn how to read and do arithmetic and communicate in writing. But there is a genuine sense in which learning to conform and follow all the rules does not expand our empathy or our community. It does not help the cause of expanded empathy that rule-making and the drumbeat of compliance are growing by leaps and bounds.
The work at hand? Remove the blocks to empathy such as dignity violations, devaluing language, gossip, shame, guilt, egocentrism, over-identification, lack of integrity, inauthenticity, hypocrisy, making excuses, finger pointing, jealousy, envy, put downs, being righteous, stress, burnout, compassion fatigue, cynicism, censorship, denial, manipulation, competing to be the biggest victim, insults, injuries to self-esteem, and narcissistic merger—and empathy spontaneously expands, develops, and blossoms. Now that is going to require some work!
Teaching empathy consists in overcoming the obstacles to empathy that people have acquired. When the barriers are overcome, then empathy spontaneously develops, grows, comes forth, and expands. There is no catch, no “gotcha.” That is the one-minute empathy training, pure-and-simple.
References and Notes
“The One-Minute Empathy Training”
May I introduce myself? Here is a short introduction to who i am and my commitment to empathy, including a one-minute empathy training. Total run time: about five minutes. Further data: See also
(c) Lou Agosta, PhD and the Chicago Empathy Project
Review: Empathy and Mental Health by Arthur J. Clark
Empathy and Mental Health: An Integral Model for Developing Therapeutic Skills in Counseling and Psychotherapy. London: Routledge 2022 Electronic Version
As a young man, Arthur J. Clark heard Carl Rogers speak and was inspired to devote his life’s work to applying empathy in education, counseling, and talk therapy. This book is the distillation of years of experience and learning, and we, the readers, are enriched and even enlightened in this original synthesis of existing ideas on empathy. It is fully buzz word compliant, diligently calls out the limitations and risks of empathy, and guides the readers in expanding their empathy to make a difference in overcoming suffering and mental illness. It takes a lot of empathy to produce a book on empathy, and empathy is evident in abundance in Clark’s work.
As noted, Clark’s academic background is in education, as was Carl Rogers’, but the reader soon discovers Clarks’ work with empathy to be generously informed by Freud, Ferenczi, and Adlerian psychoanalysis. Thus Clark quotes [Alfred] Adler (1927): “Empathy occurs in the moment one individual speaks with another. It is impossible to understand another individual if it is impossible at the same time to identify oneself with him” (Clark: 20). At this same time this reviewer was enlivened by the application of distinctions to be found in the Self Psychology of Heinz Kohut and the latter’s colleagues Michael Basch and Arnold Goldberg. This brilliant traversal of the practice and conceptual landscape of empathy inspired Clark’s life work, and is on display here.
The book is filled with short segments of transcripts of encounters between counselor/therapist and client. To the point that empathy is much broader than reflecting feeling and meanings, examples are provided of empathic encouragement, empathic being in the here and now (immediacy), empathic silence, empathic self-disclosure, empathic confrontation, empathic reframing, empathic cognitive restricting, empathic interpretation. Clark’s work with empathic reframing, cognitive restructuring, and interpretation are particularly useful (Clark: 105 – 106).
“Empathy” is not so much a substantive as a modifier – a manner of being that applies across a diversity of ways of relating to the other individual. (It is a further question, not addressed by Clark, as to the status of these vignettes. Are they disguised, permissioned, ideal types, some combination thereof? Just curious. In any case, they work well and remind me of M. F. Basch’s vignettes in the latter’s Doing Psychotherapy.)
Clark makes reference to the celebrated video (e.g., widely available on Youtube) of Carl Rogers, interviewing the real-world patient “Gloria” about her relationship with her nine-year-old daughter “Pammy.” Rogers’ empathic listening skillfully turns the focus from Gloria’s presenting dilemma of how much information about sex to share with her inquisitive nine-year-old daughter, Pammy, into a willingness on the part of Gloria’s to call out her own blind spots and conflicts over sex. Rogers’ empathic responsiveness shows the way for Gloria to recapture her own integrity around adult sexuality so that she can provide Pammy with the appropriate sex education the child needs, regardless of the details that may be relevant only to the adults. And Rogers does this in about twenty minutes, not months of therapy.
At this point, it is useful to give Rogers’ definition of empathy (p. 11): “To perceive the internal frame of reference of another with accuracy and with the emotional components and meanings which pertain thereto as if one were the person, but without ever losing the ‘as if’ condition.” Rogers was definite about excluding the perspectives of the practitioner in conceptualizing empathy in his person-centered approach to therapy. In this regard, he stated, “For the time being you lay aside the views and values you hold for yourself in order to enter another’s world without prejudice.”
Clark’s integration of the diversity of approaches to empathy in history, theory, and practice distinguishes subjective, object and interpersonal empathy: “Subjective empathy encompasses a practitioner’s internal capacities of identification, imagination, intuition, embodiment that resonate through treatment interactions with a client and empathically reflect the individual’s experiencing. Objective empathy pertains to the deliberate use of a therapist’s conceptual knowledge and data-informed reasoning in the service of empathically understanding a client in a relational climate. Interpersonal empathy relates to comprehending and conveying an awareness of a client’s phenomenological experiencing and pursuing constructive and purposeful change through the application of a range of interventions” (Clark: xiv).
Clark started out as a school counselor and he gives the example of the student who comes in and says “I hate school!” The reflection is proposed to be something like “You are feeling angry about school.” This demonstrates just how important the tone in which a statement is made can be. This could indeed be an angry statement, which takes “hate” is a literal way. However, it could also be an expression of contempt, disgust, cynicism, resignation, sadness, or even fear (say, since the student is being bullied). The empathy is precisely to acknowledge that the listener is far from certain that he does knows what is going on with the student and to ask for more data. “Sounds like you are struggling with school – can you say more about that?”
Not afraid of controversy or tough topics, Clark’s contribution is thick with quotations from the founding father of psychoanalysis – Adler and Freud and the literature Freud has been reading such as Theodor Lipps, to whom we owe the popularization in Freud’s time of the term “empathy [Einfühlung]. The subsequent generation of ego psychoanalysts is also well represented Ralph Greenson, T. Reik, Jacob Arlow (and Beres).
Clark credits and recruits Ralph Greenson’s distinction of the therapist’s inner working model of the patient and uses it to enrich Rogers’ contribution to empathic understanding. “As empathic understandings evolve through therapeutic exchanges and assessment interactions, a model of an individual emerges that becomes increasingly refined and expansive. In turn, by ways of empathically knowing a client, the framework facilitates sound treatment interventions through the engagement of interpersonal empathy” (Clark: 88). Note that Clark aligns with the view that the countertransference is distorting/pathological as opposed to the total response of the therapist. There are many tips and techniques guiding the therapist diligently to monitor and control the countertransference neurosis.
Since this is not a softball review, I note some issues for productive debate. For example, if Clark had allowed that countertransference included the therapist’s entire reaction to the client, including personal reactions which are not necessarily conflicted or neurotic (on the part of the therapist), then Clark would have been constrained to spend more ink on his own individual responses, empathic and otherwise. Such disclosure, which Clark otherwise separately validates as appropriate in context (and if not this context, then which?), would have enriched a text which otherwise reads like a textbook (and perhaps that was the editorial and marketing guidance).
Also useful is the therapist’s being sensitive to cultural differences and dynamics. In a brief transcript of an interaction between a privileged white school counselor and an African American 8th grader attending the college prep private school (Clark: 42), we are supposed to see objective cross-cultural empathy based on the counselor’s reading of some articles (not specified) on cultural differences.
By all means, read up on cultural differences. However, I just see a rigorous and critical empathy (my term, not Clark’s), plain and simple. The counselor “gets it.” The student is afraid of being seriously injured or even killed by the criminal element in his neighborhood as he waits for the school bus. Is this breakdown of policing in the inner city really in the cultural article? The counselor also “gets it” that the student’s feelings are hurt by being laughed at by his more privileged classmates because his mom is a house cleaner rather than an executive or doctor or lawyer. It is the counselor’s empathic response based on her empathic understanding of the student’s specific fear and hurt feelings that enables the student to deescalate from his problematic acting out. Even though, like most 8th graders, the student would be the last to admit he has been emotionally “touched,” he was. Thus, Clark’s empathy shines through in spite of his style-deadening need to accommodate behavioral protocols, evidence-based everything, and the plodding style of delivery consistent with training in schools of professional social work and psychology.
“Objective empathy” may seem like “jumbo shrimp,” an oxymoron. Nor is it clear how dream work, with which Clark productively engages, falls into the “objective” rubric. Yet it is a highly positive feature that Clark emphasizes and explores in detail the value of dream work.
Let one’s empathy be informed by the context: “Consider, for instance, what are the daily struggles like for a client who meets the diagnostic criteria for a bipolar disorder or attention deficit [. . . .] When giving consideration to such challenges through a framework of empathic understanding, a practitioner calls upon reputable data and a spectrum of work with individuals from diverse backgrounds in order to generate a more inclusive and accurate way of knowing a client” (Clark: 35).
And yet this precisely misses the individual who is superficially described according to labels, but has his own experience of bipolar or attention deficit. Empathy is precisely the anti-essentialist dimension, the dimension that is so pervasive in psychiatry and schools of professional psychology that replace struggling humanity with “You meet criteria for – [insert label].”
While Kohut is properly quoted by Clark as one of the innovators in empathy and Kohut’s concise definition glossing empathy as “vicarious introspection” is acknowledged, Kohut’s other definition of empathy as a method of data gathering about the other individual is overlooked. However, it aligns nicely with Clark’s description of “objective empathy.” Maybe my close reading missed something but why not just say “taking the other person’s perspective” is “objective empathy” as opposed to vicarious introspection (“subjective empathy”)?
The subtitle promises “An integrative model for developing therapeutic skills [. . . ]” Clark substantiates the need for work in critiquing all those training program that model the skill of repeating back to the client words similar to those the client expressed. “In a meta-analysis of direct empathy training, Lam et al. (2011) found that the majority of 29 studies did not clearly conceptualize or define empathy, some did not describe training delivery methods, and almost all of the initiatives failed to present evidence demonstrating individuals’ propensity to behave more empathically after training” (Clark: 140). Clark’s discussion of reframing, cognitive restructuring, and empathic interpretation are relevant and useful in overcoming what amount to a scandal in psychotherapy training.
What Clark is trying to say is this: You think you are being empathic. Think again. A rigorous and critical empathy (my phrase, not Clark’s) is skeptical about its own empathy. That does not mean being dismissive either of one’s own empathy or the struggle of the other person. It means being rigorous and critical. Empathy is made to shine in the refiner’s fire of self-criticism and a radical inquiry into one’s own blind spots.
Clark does not escape unscathed from the behavioral and observation protocol dead end. The reader will seek in vain for self-criticism or inquiry into Clark’s own blind spots – instead the reader is awash in the extensive behavioral, cognitive behavioral therapy (CBT) attempts, albeit empathically deployed, to capture therapeutic encounters in a behaviorally observable or reportable protocol. Nor I am saying there is anything wrong with that as such. Yet might not the behavioral and observation protocol swamp precisely be the blind spot where the self-deception lives against which Rogers frequently denounces? To gather the honey of self-knowledge and empathic understanding one must risk the stings of distortion and disguise.
Clark’s would be a different work entirely if he explored the college of hard knocks in which he forged the empathic integration. He is trying to make what is largely an artistic practice into a rule-governed scientific algorithm. It is worth a try and the reader must judge the extent to which Clark succeeds. Spending a lifetime preparing articles for peer-reviewed publications in education, psychology, etc., does not generally bring life and vitality to one’s practice, manner of engagement, or writing style. However, Clark’s richness of material, wealth of distinctions related to empathy, and organizing virtually every aspect of empathic research and published references goes a long way towards compensating for Clark’s work not necessarily being a “page turner.” Clark’s writing reminds the reader more of the Diagnostic and Statical Manual (DSM) – Ouch! – more than (for example) of D. W. Winnicot, Christopher Bollas, Arnold Goldberg, Freud, who was an expert stylist (granted much is lost in translation), or even Carl Rogers himself.
Thus, Clark’s integrated approach calls for “a diagnosis [as from the DSM] that represents the lived experience of the individual.” Agree. Clark gives an example where the therapist is interviewing Omar who has low energy, lethargy, lack of motivation, and hopelessness about the future. The diagnosis encapsulates and integrates a lot of Omar’s experience, and, though Clark does not say so, Omar may even be relieved to hear/learn that he (Omar) is not to blame for his disordered emotions (“major depression”); and Omar should stop making a bad situation worse by negative self-talk, verbally “beating himself up” in his own mind. The treatment consists in getting Omar to do precisely what the depressed person is least inclined to do – take action in spite of being unmotivated. If one is waiting to be motivated, absent a miracle, it is going to be a long wait. Maybe the empathic response is precisely saying this to the client, acknowledging how hard it is (and may continue to be for a while) to get into action on one’s own behalf.
This is all well and good. However, narrowly or expansively empathy is defined it is the anti-DSM (diagnostic and statistical manual). The DSM has many uses, especially in aligning terminology such that the community is talking about the same set of criteria when it uses the word “generalized anxiety disorder.” It also has uses in requesting insurance reimbursements. In short, there is nothing wrong with the DSM-5 (2013) or any version – but there is something missing – empathy. In the case of empathy, the recommendation is to relate to the struggling human being who presents himself in therapy, not to a diagnostic label.
Thus, Clark makes the case in his own terms: “From a humanistic perspective with central tenets focusing on respect for the individuality and uniqueness of a person, employing the DSM to categorize clients through a labeling procedure is thought to impede the growth of authentic relationships and empathic understandings of a deeper nature. In this regard, in a human encounter, perceiving a client through categorical frames of reference and symptomatic functioning hinders an attunement with the individual’s lived experiences and personal meanings. Moreover, applying a label to a client possibly influences a practitioner to shape preconceptions that are objectifying and forecloses a mutual and open-minded exploration of the contextual existence of the individual” (Clark: 27).
Though Clark does not say so, almost every major mental illness involves a breakdown of empathy. The patient experience isolation. “No one ‘gets’ me.” “No one understands what I am going through.” This is the case with most mood disorders, thought disorders, as well as those disorders typically described as “disorders of empathy” such as some versions of autism spectrum and anti-social personality disorders.
One matter of editing detail may be noted, a consistent misspelling of the name of celebrated primate researcher, philosopher, and empathy scholar Frans de Waal. There are no “Walls” in de Waal’s name – or in his empathy! We will charge this wordo to the editors who otherwise perform an admirable job.
Returning to a positive register, one of the most important takeaways from engaging with Clark’s work is that short therapy in which empathy is the driving force is powerful and effective. Clark does not specify the elapsed treatment in most cases, but I did not find one that was explicitly called out as being longer than fourteen weeks.
The emphasis is on the use of empathy in relatively brief psychotherapy – which is a powerful and positive approach that pushes back against the assertion that one needs cognitive behavioral therapy for relatively time-constrained encounters. Empathy produces quick results when skillfully applied. It is true that one of the great empathy innovators, Heinz Kohut, had some famous long and multi-year psychoanalyses; but these individuals were significantly more disturbed than Clark’s example of Anna, whose presenting behaviors were largely social awkwardness.
A strong point of Clark’s work is his debunking of the caricature of Rogers definition of empathy (and indeed of empathy itself) as merely reflecting (i.e., repeating) back to the speaker the words that the speaker has said to the listener. There is nothing wrong as such with reflecting what the other person has said, especially if the statement is relevant or well expressed. However, the mere words are pointers to the other person’s experience and are not reducible to the mere words. This is not a mere behavioral skill of reflecting back language, but a “being with” the other in the complexity and depth of the other’s experience as refined in the therapist’s own experience, and that is something one can best learn in years of one’s own dynamic therapy. Additional processing of the other person’s experience is encapsulated by and captured in the other person’s words, but not reducible to the words. The aspects of empathic responsiveness, embodiment, acknowledgement, recognition, encouragement, immediacy, possibility, clarification, and validation of the other’s experience form and inform the empathic response and the reply to the other.
A rumor of empathy is no rumor in the case of Clark’s work – empathy lives in his contribution to integrating the diverse and varied aspects of empathy.
Edwin Rutsch interviews the author Arthur J. Clark:
(c) Lou Agosta, PhD and the Chicago Empathy Project
The Empathy Diaries by Sherry Turkle (Reviewed)
Read the review as published in abbreviated form in the academic journal Psychoanalysis, Self, and Context: Click here
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.
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 about the breakthroughs and breakdowns of empathy in her family of origin and subsequent life.
Families have secrets, and one was imposed on the young Sherry. Sherry’s mother married Charles Zimmerman, which became her last name as Charles 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, more about this shortly.
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 is 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.
Mom gets rid of Charles and within a 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 is willing 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 issue 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 Sherry’s 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.
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 professor’s 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 Riesman (The Lonely Crowd) and other less famous but equally inspiring teachers.
Turkle 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” Jacques 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. Jacques 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 colleagues 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 everyone’s 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.
Turkle’s 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, autistic, 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.
On a personal note, 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 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 Bellow 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
Empathy: Top Ten Trends for 2022
A new year and a new virus variant? Being cynical and resigned is easy, and the empathy training is to drive out cynicism and resignation – then empathy naturally comes forth. If given half a chance, people want to be empathic. The prediction is that with a rigorous and critical empathy (and getting a very high percent of the population vaccinated), we are equal to the challenge.
Setting priorities is an art, not a science. It is clear that empathy is a priority, not a mere psychological mechanism, a practice and a way of being in the world, creating a safe space of openness, acceptance and toleration. In the face of a contagion of Omicron, we need a contagion of empathy. Empathy is contagious. This is one you want to give to someone else, especially someone who seems to need some – all the while being clear to set firm boundaries against bullying, delusional thinking, and compassion fatigue. Keep in mind this list is a top ten “count down,” so if you want to know what is #1, fast forward to the bottom.
Here are my choices and predictions for the top ten trends in empathy for the year 2022.
(10) Delays in the empathy supply chain continue to thwart the expansion of empathy in the community.
This does not refer to the distribution of cat food or toilet paper. Empathy is available. There is enough empathy to go around, but the empathy is poorly distributed due to politics, in the pejorative sense. For example, most medical doctors are empathic and they become MDs because they want to make a difference in relieving human suffering. But the corporate transformation of American medicine means they are given onerous “capitation” quotas – they must see thirty patients a day. The coaching and push back is based in empathy: It is a breach of professional ethics not to give a given patient the time and attention s/he deserves, and there is only time to see twenty two patients a day.
(9) Republicans and Democrats will start conducting Empathy Circles where they get together and listen to one another and respond empathically.
And if you believe this, I have a famous bridge in Brooklyn to sell to you. Yet the key to expanding empathy is to drive out cynicism and resignation. Be open to the possibility: On a more realistic note, the responsibility of leadership, whether in the political or corporate jungle, requires teaching critical thinking. Critical thinking includes skills to analyze conflicting articles in the press, chasing down media reports to their sources and assessing the sources for reliability. Most importantly, critical thinking includes temporarily taking the opponent’s point of view, which is a version of cognitive empathy. One does this not to agree with the opponent, but to have a productive disagreement. Empathy brings workability to political, business, and personal relations. It is like oil to reduce friction and produce results that benefit the entire community. (Edwin Rutsch and The Culture of Empathy are going to like that one!).
(8) Being empathic is hard within the Patriarchy. This does not go away.
The dystopia of Patriarchy (systematic unspoken sexism) crushes the empathy and compassion out of all of us. This is an issue because: in the face of so much gender violence (the vast majority of which is men perpetrating boundary violations against women), can we find or recover a shred of our humanity? I do not need to say “shared humanity,” because “unshared humanity” is not humanity.
It gets worse: the company formerly known as Facebook re-launches as Meta and the Metaverse, a virtual reality world. A quote from the New York Times (12/30/2021): “But as she waited, another player’s avatar approached hers. The stranger then simulated groping and ejaculating onto her avatar, Ms. Siggens said. Shocked, she asked the player, whose avatar appeared male, to stop.” He shrugged as if to say: ‘I don’t know what to tell you. It’s the metaverse — I’ll do what I want,’” said Ms. Siggens, a 29-year-old Toronto resident. “Then he walked away.”” (I do not want to give Metaverse its own trend.) [https://www.nytimes.com/2021/12/30/technology/metaverse-harassment-assaults.html] A specific proposal includes: establish a Desmond Tutu style Truth and Reconciliation commission in the Metaverse where perpetrators can tell the survivors what they did and ask forgiveness. Another proposal: establish empathy circles in the Metaverse (Edwin Rutsch and The Culture of Empathy are going to like this one too!).
Recall that instead of a civil war, South Africa and the late Desmond Tutu innovated a Truth and Reconciliation program for the perpetrators of apartheid to tell the truth about what they did to the victims and to ask forgiveness. The survivors then got to say if and/or what they could see there to forgive. That would be a practical, albeit utopian response. I am no fan of forgiveness, which I consider overrated. But I bought Tutu’s book based on the title, No Future Without Forgiveness. How can there be? It both requires empathy and expands empathy. Empathy is both the cause and the effect. I hasten to add that it does not mean being nice; it means establishing firm boundaries. It does not even mean going in with a forgiving attitude, but actually striving for actual truth and reconciliation tribunals, seeing if the truth on the part of the perpetrator(s) can show forth some shred of humanity and maybe, just maybe, highly unlikely though it is, point to a future of cooperation, communication, and community in which both parties flourish. I am not looking for moral equivalence, clever slogans, or easy answers here, I am looking for expanded empathy!
(7) Along the same lines as (8), the so-called “incel” (“involuntary celibate”) gets empathy, backs away from the ledge, gets in touch with his inner jerk and stops being one. (What the heck is an “incel”?)
Now I hasten to add that as soon as a person, whether incel, Don Juan, or one of the Muppets, picks up a weapon, a date rape drug, or proposes to act like the incel and mass killer Elliott Roger, that is no longer a matter for empathy, but for law enforcement. (For more on what is an incel – this is genuinely new – see the blog post and book review: The Holocaust of Sex: The Right to Sex by A. Srinivasan (reviewed) (https://bit.ly/3EACv7W).
After incarcerating or canceling or cognitive behavioral theraputizing the incel, let us try engaging him with – empathy. Key term: empathy. Let us take a walk in his shoes. Knowing full well that the incel is like a ticking bomb, let us engage with one prior to his picking up a weapon. I cut to the chase. It is not just sexual frustration, though to be sure, that is a variable. There is also a power dynamic in play. This individual has no – or extremely limited – power in the face of the opposite sex. He is trying to force an outcome.
Here we invoke Hannah Arendt’s slim treatise On Violence. Power down, violence up. Whenever you see an individual (or government authority) get violent, you can be sure the individual (or institution) has lost power. The water cannon, warrior cops, and automatic weapons show up. The incel embraces his own frustration like Harlow’s deprived Macaque monkeys embraced their cloth surrogate mother, even though it lacked the nipple of the wire-framed one.[3] Now I do not want to make light of anyone’s suffering and incels are definitely suffering. Yet it is tempting to enjoy a lighter moment. The incel’s dystopian life points to his utopia, which consists in two words: “Get laid.” I would add: this applies to consenting adults, and don’t hurt yourself!
(6) Burned out MDs, teachers, flight attendants dealing with delusional angry unvaccinated and sick people don’t get no empathy – how does empathy make a difference?
Set boundaries with and against bullies. At least initially, establishing boundaries is not about having empathy for the bully; it is about being firm about damage control and containing the bullying. Ultimately the bully benefits even as the community is protected from his perpetrations; but more in the manner of a three year old child, who, having a tempter tantrum, benefits from being given a time-out in such a way that he cannot hurt himself or others.
Without empathy, people lose the feeling being alive. They tend to “act out”—misbehave—in an attempt to regain the feeling of vitality that they have lost. Absent an empathic environment, people lose the feeling that life has meaning. When people lose the feeling of meaning, vitality, aliveness, dignity, things “go off the rails.” Sometime pain and suffering seem better than emptiness and meaninglessness, but not by much. People then can behave in self-defeating ways in a misguided attempt to awaken a sense of aliveness.
People act out in self-defeating ways in order to get back a sense of emotional stability, wholeness and well-being—and, of course, acting out in self-defeating way does not work. Things get even worse. One requires expanded empathy. Pause for breath, take a deep one, hold it in briefly while counting to four, exhale, listen, speak from possibility.
(5) Nursing schools and schools of professional psychology and medical schools begin offering classes in empathy.
Yes, it is a scandal you cannot take a course entitled “Empathy Dynamics” or “Empathy: Concepts and Techniques” in any of these schools. I know, because I checked the catalogs [Q3 2021]. I even got hired once or twice to fill in because they could not get anyone else to do it. You may say, “Well, every course we have teaches empathy” and in a sense, it does – or at least ought to. But that is mainly wishful thinking – if you don’t practice empathy, you don’t get it right or wrong – and if you don’t get it wrong, at least occasionally, you don’t expand the skill.
(4) Combine empathy with critical thinking – the result is a rigorous and critical empathy.
I got this distinction – a rigorous and critical empathy – from Xavier Remy, who I hereby acknowledge. What does that mean? You think you are being empathic – think again. It may be empathy or it may be narcissism or rational compassion or pity or self-congratulations or a whole host of things related to empathy, but not empathy. How do you tell? Empathy tells you what the other person is experiencing – be open to their experience, understand the possibility – take a walk in their shoes – acknowledge the shared humanity. Empathy tells what the other person is experiencing – critical thinking tells you what to do about it.
(3) Empathy builds a bridge over the digital divide and encounters resistance to empathy online and in-person.
With the pandemic of 2020, many in person services such as psychotherapy, life coaching, empathy consulting, and others went online. When the provider is having a conversation, then an online session is often good enough – and is definitely better than ending up in the hospital on a ventilator.
As the pandemic wanes and virus variants (hopefully) actually become more like a bad case of the flu (which indeed kills the most vulnerable), the issue becomes when to stay online, meet in person (with fully vaccinated clients), and how to tell the difference?
The disturbing trend that I see amongst (some) behavioral health professionals is that online “better than nothing” becomes “better than anything.” Going online is very convenient, and since, as the saying goes, inertia is the most powerful force in the universe, providers prefer to stay home rather than risk being vulnerable in creating a space of acceptance and tolerance in being personally present physically. The latter is a definition of empathy in the expanded sense – being fully present with the other person – in person and unmediated by a screen.
Now when I call out this conflict of interest, generally based in financial and time considerations (and time is money), most providers acknowledge that the commitment is not to online versus in-person, but rather to client service, delivering empathy, and making a positive difference for the client.
Clients whose mental status is “remote” even in-person in a physical, shared space present a challenge to the therapist’s empathy and are not initially a good choice to work with remotely online. However, after a warming up period the empathic relatedness migrates quite well to the online environment.
“Better than nothing” versus “better than anything” is a choice that needs to be declined: both online and in-person physical therapy coexist and help clients flourish using empathy to bridge the digital divide.
(2) Empathy and climate change. Empathy is oxygen for the soul – individually and in community.
In a year when the lead off comedy is about the destruction of the Earth by a killer comet – and a metaphor for global warming – empathy is oxygen for the soul. This is supposed to be funny (think of the film Dr Strangelove (1964)), in both cases, featuring an arrogant clueless President, played by Meryl Streep (instead of Peter Sellers). Empathy builds ever expanding inclusive communities – empathy is oxygen for the soul – and the planet.
“Beggar thy neighbor politics, economics, and behavior do not work.” They did not work in the Great Depression of 1929 – they did not work in the Great Recession of 2008. Do not take a bad situation and make it worse. Take a pandemic – now fist fights break out on airplanes, hospital emergency rooms, and retail stores. Hmmm.
It is a common place that empathy is oxygen for soul. If the human psyche does not get empathy, it suffocates in stress and suffering. Climate change makes the metaphor actual. If we do not drown as the Greenland and Antarctic ice fields slide en masse into the oceans, we are surely doomed to suffocate as the levels of carbon dioxide and heat overwhelm temperate habitats. Most people are naturally empathic and they an expanding appreciation of empathy suffuses the community.
The problem is that this eventuality does not live like an actual possibility for most people, who cannot imagine such an outcome – for example, just as in December 2019 no one could envision the 2020 pandemic. The bridge between the gridlocked present and a seemingly impossible-to-imagine future is empathy. The empathic moment is an act of imagination. That is the interesting thing about empathy. It may seem like a dream; but the dream lives. It is inclusive. Lots more work needs to be on this connection. For purposes of this list of tasks, this “shout out” will have to suffice. For specific actionable recommendations, see David Attenborough’s A Life on Our Planet, now streaming on Netflix: https://www.netflix.com/title/80216393
And, [drum roll] the number one empathy trend for 2022 is: –
(1) There is enough empathy to go around – people get vaccinated, boosted, and – get this – people get what seems like a version of the common cold – the pandemic “ends,” not with a bang but a whimper.
This relates to issues with the empathy supply chain, but deserves to be called out on its own. Granted, it does not seem that way. It seems that the world is experiencing a scarcity of empathy – and no one is saying the world is a sufficiently empathic place. Consider an analogy. You know how we can feed everyone on the planet? Thanks to agribusiness, “miracle” seeds, and green revolution, enough food is produced so that people do not have to go hungry? Yet people are starving. They are starving in Yemen, Africa, Asia – they are starving in Chicago, too.
Why? Politics in the pejorative sense of the word: bad behavior on the part of people, aggression, withholding, and violence. The food is badly distributed. Now apply the same idea to empathy.
There is enough empathy to go around – but it is badly distributed due to bad behavior, politics and interpersonal political in the pejorative sense. The one-minute empathy training? Drive out the aggression, bullying, shaming, integrity outages, and so on, and empathy naturally comes forth. (For further particulars, see the video cited in the References.) People are naturally empathic, and the empathy expands if one gives them space to let it expand.
Empathy is not a mere psychological mechanism (though it is that too), but is an enlarged concern for the other person – one’s fellow human being on the road of life. Empathy has been criticized for working better with one’s own family than with strangers – but these critics do not know my family – okay, joke – but, even if accurate, the solution to lack of empathy for strangers is expanded empathy. Be inclusive. Be welcoming. Expand the community of inclusiveness. All of this is consistent with people with underlying medical conditions needing to take extra precautions. In that sense, people who get vaccinated, boosted, and mask up, are doing it to keep their neighbors from getting sick. And, so, out our concern for others – our fellow humans – we get vaccinated, boosted, masked-up, and the pandemic ends – but – aaahhh, cooh! – the common cold continues to live on.
References / Notes
[1] Harlow, H. F. (1958). The nature of love. American Psychologist, 13(12), 673–685. https://doi.org/10.1037/h0047884
“The One-Minute Empathy Training” [https://youtu.be/747OiV-GTx4: May I introduce myself? Here is a short introduction to who i am and my commitment to empathy, including a one-minute empathy training. Total run time: about five minutes. Further data: See http://www.LouAgosta.com]
(c) Lou Agosta, PhD and the Chicago Empathy Project
Lou Agosta, Ph.D., Listening With Empathy 