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Left stranded when the music stops: What to do about the shortage of talk therapists actually available
An article in the Washington Post by Lenny Bernstein: “This is why it is so hard to find mental health counseling right now” (March 6, 2022) struck a chord with many readers.[1]
The article begins by describing an individual in the Los Angeles area who said she was willing to pay hundreds of dollars per session and called some twenty-five therapists in the area but was unable to find an opening. The person willingly shared her name in the article. Be careful not to blame the survivor or victim – the report is credible – and she maintained a spreadsheet!
One of the main points of the article is that after several years of pandemic stress prospective clients and patients are at the end of their emotional rope and providers (therapists) are over-scheduled and burned out too. No availability.
The problem is systemic. There seems to be no bottom in sight as regards the opportunistic behavior of insurance companies, the lack of behavioral health resources, and the suffering of potential patients. The WP article goes on to document other potential patients with significantly less resources who cannot even get on a wait list. The article documents third party insurance payers whose “in network” providers are unwilling to see prospective patients due to thin
reimbursements from the payer – once again, the individual is unable to get on a wait list or get help urgently needed; supply side shortages are over the top in the programs that train psychiatrists, a specialty in medicine. Psychiatrists, when available, are most often interested in lucrative fifteen-minute medication management sessions, but unless they are “old school” and were psychoanalytically trained in the “way back,” they are rarely available for conversations. This all adds up to a crisis in the availability of behavioral health services.
This leads to my punch line. Often time depression, anxiety and emotional upset are accompanied by negative self-talk, shaky or low self-esteem. One reaches out and asks for help but instead has an experience of powerlessness that is hard to distinguish from the original emotional disequilibrium. The conversation spins in a tight circle – “maybe I deserve it – no I don’t – this sucks – I suck – help!” The person resigns himself to alife of gentile poverty, thinking she or he is not worthy of financial well-being. The prospective patient is left aggrieved. This grievance is accurate and real enough in context, but it is hard to identify what or who can make a difference. Nevertheless, there is no power in being aggrieved. One still has to do the thing the person in distress or with shaky self-esteem is least inclined to do – invest in oneself because one is worth it!
I have spoken with numerous potential and actual clients who pay a lot of money for health insurance. However, when they want to use the insurance for behavioral health services, they find the insurance is not workable. Not usable. The service level agreement is hard to understand, and having a deductible of a couple of thousand dollars is hard to distinguish from having no insurance at all. If the client goes “in network,” the therapists are unresponsive or inexperienced. If the client goes out of network, the therapists are often more experienced and able to help, but onerous deductibles and copays rear their heads. Why don’t the experienced therapists go in network? There are many reasons but one of them is that the insurer often insists the therapist accept thirty cents on the dollar in compensation, and some therapists find it hard to make ends meet that way. In short, as a potential patient, you think you have insurance, but when it comes to behavioral health, you really don’t.
My main point is to provide guidance as to some things you can do to get the help you need with emotional or behavioral upset and do so in a timely way. Turns out one has to give an informal tutorial on using insurance as well as on emotional well-being. I hasten to add that “all the usual disclaimers apply.” This is not legal advice, medical advice, insurance advice, cooking advice or any kind of advice. This is a good faith, best efforts to share some brain storming and personal tips and techniques earned in the “college of hard knocks” in dealing with these issues. Your mileage may vary.
Nothing I say in this article should be taken as minimizing or dismissing the gravity of your suffering or the complexity of this matter. If you are looking for a therapist or counselor, it is because you need a therapist or counselor, not a breach of contract action against an insurance company. You want a therapist not a legal case or participation in a class action law suit, even if the insurance contract has plenty of “loop holes.” For the moment, the latter is a rhetorical point only.
When a person is anxious or depressed or struggling with addiction or other emotional upset, being an informed assertive consumer of behavioral health services is precisely the thing the person is least able to do. “I need help now! Shut up and talk to me!”
Notwithstanding my commitment to expanding a rigorous and critical empathy, here’s the tough love. Without minimizing your struggle and suffering, the thing you least want to do is what you are going to have to try to do. If one is emotionally upset, the least thing you want to do is be an assertive consumer of services designed to get you back your power in the face of emotional upset or whatever upsetting issues you are facing.
The recommendation is to speak to truth to power and assertively demand an “in network” provider from the insurance company or invest in yourself and pay the private fee for an experienced therapist whom you find authentically empathic, then you already be well on the way to getting your power back in the face of whatever issues you are facing.
If your issue is that you really don’t have enough money (and who does?), then you may need to get the job and career coaching that will enable you to network your way forward. An inexpensive place to start is The Two Hour Job Search by Steve Dalton. Highly recommended. Note the paradox here – the very thing you do not want to do keeps coming up. You definitely need someone to talk to. Once again, the very things with which you need help are what re stopping you from getting help
The bureaucratic indifference of insurance companies is built into the system. The idea of an insurance is a company committed to making money by spreading risk between predictable outcomes and a certain number of “adverse” [“bad risk”] events. It is not entirely fair (or even accurate) but by becoming depressed or anxious (and so on), you are already an adverse event or bad risk waiting to happen. You may expect to be treated as such by most insurance companies.
In a health insurance context, the traditional model for the use of services is a broken arm or an appendicitis (these are just two examples among many). You definitely want to have major medical insurance against such an unfortunate turn of events. Consider the possibility: Buy major medical only – and invest the difference saved in your therapy and therapist of choice.
But note these adverse medical events are relatively self-contained events – page the surgeon, perform the operation, take a week to recover or walk around in a sling for awhile. The insurance company pays the providers (doctors and hospitals) ten grand to thirty grand. That’s it. With lower back pain, headaches, irritable bowel syndrome, autoimmune disorders, it is a different story. These are notoriously difficult to diagnose and treat. Yet, modern medicine has effective imaging and treatment resources that often successfully provide significant relief if not always complete cures for the patient’s distress in these more complex cases.
Consider similar cases in behavioral health. Start by talking to your family doctor. Okay, that is advice – talk to your family doctor for starters. Front line family doctors have the authority – and most have the basic training – needed to prescribe modern antidepressants (so called SSRIs), which also are often effective against anxiety, to treat simple forms of depression and anxiety due to life stresses such as an ongoing pandemic, job loss, relationship setbacks.
Even though I am one of the professionals who has consistently advocated “Plato not Prozac,” I acknowledge the value of such psychopharmacological interventions from a medical doctor to get a person through a rough patch until the person can engage in a conversation for possibility and get at the underlying cause of the emotional disequilibrium. Note this implies the person wants to look for or at the underlying dynamics. This leads us to the uncomfortable suggestion that it is going to take something on the part of the client to engage and overcome the problem, issue, upset, which is stopping the client from moving forward in her or his life.
There is a large gray area in life in which people struggle with relationship issues, finances, career, education, pervasive feelings of emptiness, chronic emotional upset, self-defeating behavior in the use of substances such as alcohol and cannabis (this list is not complete).
A medical doctor or other astute professional may even provide a medical diagnosis when the interaction of the person’s personality with the person’s life falls into patterns of struggle, upset, and failure. Insurance companies require a medical diagnosis. One thinks of such codable disorders as adjustment disorder or personality disorders (PD) such as narcissistic, histrionic, schizoid, antisocial, or borderline PD. These are labels which can be misleading and even dangerous to apply without talking to the person and getting to know them over a period of time. It’s not like the Psychology Today headline – top three ways to know if you are dating a narcissist. I am calling “BS” on that approach.
Nevertheless, if after a thorough process of inquiry, some such label is appropriate (however useless the label may otherwise be except for insurance purposes), then the cost will be right up there with “fixing” an appendicitis – only you won’t be able to do it in a single day – and it won’t be that kind of “fix”. An extended effort and of hard to predict duration must be anticipated, lasting from months even to years. This is not good news, but there are options.
My commitment is to expanding a rigorous and critical empathy in the individual and the community. I consider that I am an empathy consultant, though at times that is hard to distinguish from a therapeutic process and inquiry into the possibilities of health and behavioral well-being. Therefore, and out of this commitment, I have a sliding scale fee structure for my consulting and related empathy services. People call me up and say “I make a lot of money, and want to pay you more.” Of course, that is a joke. I regularly hear from prospective clients whose first consideration is financial. They do not have enough money. I take this assertion seriously, and I discuss finances with them. Between school debt and the economic disruptions of three years of pandemic, people are hurting in many ways including financially. One must be careful NEVER to blame the victim or survivor.
The best way for such financially strapped individuals to go froward is to find an “in network” provider. Key term: in network. But we just read the Washington Post article that furnishes credible evidence such networks are tapped out, in breakdown, not working. Those that are working well enough often deal with the gray area of emotional upset and life challenges by moving the behavioral health component to a separate corporate subsidy at a separate location to deal with all aspects of behavioral health. (See above on “bad risk.”) When I had such an issue years ago, I had to search high and low to get the phone number, web site, or US postal address. You can’t make this stuff up. This is because ultimately, the issues that come up are nothing like an appendicitis or even hard to diagnose migraines. Moving the paying entity to a corporate subsidy is also a way that the insurance company can impose a high deductible and/or copay by carving out that section of the business and claims processing. There are other reasons, too, but basically, they are financial.
You may be starting to appreciate that many health insurance contracts are not really designed to provide behavioral health services (e.g., therapy) the way they are designed to address a broken leg or appendicitis. There is a way forward, but it is more complex (and expensive in terms of actual dollar, though not necessarily time and effort). I will address this starting in the paragraph after next, because, sometimes in the case of behavioral health, people who have insurance do not really have useable, workable behavioral health insurance. For all intents and purposes, they think they have insurance, but, in this specific regard, they have a piece of paper and a phone number that is hard to find. I hasten to add I am not recommending going without major medical health insurance, inadequate though it may be in certain respects.
This brings us to those individuals who decide to go without insurance. What about them? Such individuals choose to take the risk. They are living dangerously because if they do break an arm or incur an appendicitis, then they are going to have another $30K in medical debt [this number is approximate and probably low], along with a mountain of school debt, credit card debt, and bad judgment debt (this list is not complete). These good people need insurance, not so much to get therapy – because, as the accumulating evidence indicates, it really doesn’t work that way – as to be insured against a major medical accident. Many people are not clear on this distinction, but I would urge them to consider the possibility.
I spoke with this one prospective client who began with a long and authentically moving narrative that she did not have enough money and could not afford therapy. This is common and not particularly confidential or sensitive. As part of a no fee first interview to establish readiness for therapy, I acknowledged her courage in strength in reaching out to someone she did not really know to get help with her problems. I acknowledged that one of her problems was she did not have enough money. A bold statement of the obvious. I asked if there was anything else she wanted to work on. It turns out that she was a survivor of a number of difficult situations and would benefit from both empathy consulting, and talk therapy – and I might add job coaching. Here’s the thing – when a person is hurting emotionally, they do not want to look for another job – or a better job that pays more money. But one just might have to do that, at least over the short term, with someone who can provide that kind of guidance to those who are willing. I encouraged her to be assertive with her insurance company and I heard she found someone in network at a low rate.
And if you are a therapist who believes such job coaching compromises the purity or neutrality of the therapy, I would agree. However, never say never. In the aftermath of World War I, when the victorious allies maintained a starvation blockage on Germany and Austria even into 1919, Freud (that would be Sigmund) was reportedly seeing a client in exchange for a substantial bag of potatoes. I have no facts – none – but I find it hard to believe they were discussing matters pertinent to individual and collective survival. So far no one has offered me a bag of potatoes (I am holding out for a quantity of olive oil and basil to make pesto), but see the above cited article from the Washington Post.
We circle back to where we started. If the individual named in the Washington Post article has not yet found a therapist, then I believe there are many in the Chicago area would welcome the opportunity to make a difference for her. She has a budget for therapy, she says. If you have a budget, the work goes forward. It can be confronting and difficult to contemplate, but if you were buying a car, you would look at your budget. If you were planning a vacation, you would think about your vacation budget. If you were thinking of going back to school, you would look at your education budget. You get the idea. What is your budget for empathy consulting, counseling, talk therapy, cognitive retraining, life coaching, or medication management services (this are all distinct interventions, appropriate in different circumstances)? Zero may not be the right number. Just saying. Of course, if the client is in LA and the empathy consultant is in Chicago, it would be a conversation over Zoom. That starts a new thread so I may usefully clarify that I prefer to meet with people in person – the empathy is expanded in person – but the genie is out of the bottle and online can be good enough in some circumstance. (See my peer reviewed article “The Genie is Out of the Bottle”: https://bit.ly/37vxJ0L.)
The insurance system is broken as regards behavioral health (as evidenced by the WP article). There is a vast gray area of people with modest emotional disregulation who genuinely need help. These are not only the “worried well,” but people whose understandable lack of assertiveness in navigating an indifferent (and it must be said unempathic) bureaucracy leaves them high and dry with their moderate but worsening emotional, spiritual, and behavioral upsets. These people deserve help, and are entitled to it even under the specific terms of their insurance contracts. Indeed they are entitled to help even if they do not have insurance, though the revenue model is simpler in that case, though not less costly.
The insurance company has been unable to make money off of this gray area – therefore, the insurance company does what it does best – it turns to making money off of you. But you need health insurance against a major medical event or accident. You want a therapist, not a breach of contract case in small claims court (where the small claim often goes up to $100k). Therefore, it does little good to document having called ten or twenty-five in network providers with no result. Or does it? You – or a class action attorney firm – have a case for breach of contract. Go out of network and forward the invoices to the payer by mail with a tracking number, requesting that the full therapy fees be treated “in network” for purposes of reimbursement, and, therefore, no or low deductible and copay. Of course, one would have to have funds for that upfront, and lack of money is where this circle started. Back to expanding one’s job search skills?
This is crazy – and crazy making behavior – though only as a function of a system that is crazy. You see the problem. I’ll bet dollars to donuts that the insurance payer, when confronted with an actual summons to small claims court, would then find you a therapist – of course, the therapist might be relatively inexperienced or someone who (how shall I put it delicately?) is less motivated than one might hope. Thwarted again!
As I wrap up this post, it occurs to that while it would be crazy for an individual to seek legal redress – it might even be “acting out,” there might be a basis for an enterprising law firm to establish a system wide “class action” for breach of contract. This will not solve your problem of getting help in the next two weeks, but it might be a necessary step to benefit the community. You know the insurance company has the money!
As noted above, your grievance in being over sold unworkable behavioral health insurance may be [is] accurate and real. Nevertheless, I am sticking to my story: the guidance: there is no power in being aggrieved. You still have to do the thing the person in upset or with shaky self-esteem is least inclined to do – dig down, including into your pockets, and find self-confidence – or enough self-confidence for the moment – and invest in yourself because you are worth it!
The one minute empathy training – runtime is actually five minutes, but a personal introduction is included: https://youtu.be/747OiV-GTx4
[1] https://www.washingtonpost.com/health/2022/03/06/therapist-covid-burnout/
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
Empathy and the Novel by Suzanne Keen (Reviewed)
Suzanne Keen’s Empathy and the Novel (2007, Oxford University Press, 242 pp.) can be read as an introduction to empathy studies, fiction (novel studies), and reading in the enlarged sense of engaging with the Humanities. Keen’s approach to these intersecting discourses is nuanced, subtle, and not easily summarized. She provides a great springboard for further conversations, elaborations, and social psychology experiments.
The usual definitions of empathy are reviewed, especially: a vicarious, spontaneous sharing of affect (2007: 4). I would add: talking a walk in the other person’s shoes; transiently, temporarily, and selectively identifying with the other person; appreciating who the other person is being as a possibility; feeling and experiencing vicariously what the other person feels and experiences; being fully present with the other person in such a way as to acknowledge and respond to the other’s humanity. Keen’s book is fully buzzword compliant, including accounts of theory of mind, mirror neurons, and storytelling.
A significant aspect of the interest in relating empathy and the reading of fiction, especially novels as in Keen’s book, is to make the world a better place. Read some quality fiction; expand one’s empathy; and take action to improve the world. Wouldn’t it be nice?
Keen notes: an ideal type case is that of Harriet Beecher Stowe’s Uncle Tom’s Cabin (1852), which, in its time, was a run-away best seller, opening the eyes of contemporaries to the injustices and inhumanity of slavery, furthering the cause of abolition. Even if such a book as Stowe’s did not directly create a social movement, with the benefit of 20-20 hindsight, it is notable as representing a parallel and behind the scenes shift in the prevailing values of the community. (Sinclair’s The Jungle or Dickens’ Oliver Twist might be added to the list of influential works (2007: 118)). And yet the libraries are overflowing with novels that did not make a difference and are read by few.
Due to the importance of the empathy-altruism hypothesis developed by C. Daniel Batson, Suzanne Keen begins her book on Empathy and the Novel with Batson’s hypothesis and its relation to the practice of reading fiction.
At the risk of oversimplification, I gloss the subtleties and what the empathy-altruism hypothesis gets right: empathy creates a clearing for the prosocial, helping behaviors of altruistic behavior such as one finds in Good Samaritan scenarios. When read judiciously, this hypothesis neither reduces altruism to empathy, nor vice versa. Experimental subjects who are empathically “primed” find that their “empathy” understood as prosocial engagement spontaneously manifests itself in the direction of altruism when challenged to do so. Nevertheless, Batson’s work is a masterpiece of studied ambiguity when it comes to deciding where the boundary lies between empathy and altruism.
Keen’s approach privileges the novel, in which the fictional world brings forth a “safe space,” in which empathy can be applied without requiring that anyone take action: “…[F]ictional worlds provide a safe zone for readers’ feeling empathy without a resultant demand on real world action” (2007: 4). That is quite appropriate from the perspective of a professor of English literature. However, one might just as well reverse the equation. Empathy creates a clearing for acceptance and toleration within which the imagination performs its work of capturing experience as a narrative in which the empathic exchange of emotional and imaginative psychic contents occurs.
My position in the matter is: Empathy opens us to (“tells us”) what the other person is experiencing; our good upbringing, morals, ethics, and professional practices tell us what to do about it. This makes it sound like empathy is a mode of observation or perception, and it is indeed that. However, insofar as empathy is something that requires two people in interaction, the empathizer is required to perform an empathic response in order to complete the loop and validate the empathic interaction.
One key point of debate is whether reading novels expands a person’s empathy. Though Keen is inclined to favor this hypothesis, she marshals significant evidence on both sides of the debate and concludes that the jury is still out.
The literary career of empathy (Keen’s incisive phrase) extends from 18th century warnings by the clergy and other learned men that novel reading ranks among the incentives to the seduction of female readers (Keen, 2007: 37) all the way to the enlightenment philosophers such as David Hume and, finally, Percy Bysshe Shelley’s guidance to extend the sympathetic imagination to feel with others. “Sympathetic” because the word “empathy” had not yet been coined in the English language (which would happen in 1909 as E. B. Titchener’s translation of the German “Einfühlung”). Fast forward to James Joyce, Sam Beckett, and Berthold Brecht, who become anti-empaths, privileging defamiliarization and estrangement in narrative.
The moral peril of vicarious emotions to the innocence of girls becomes the emotional contagion that Brecht sees as subverting the consciousness raising of the workers and potential for revolutionary action of the working class by means of his Epic Theatre. None of this is full blown adult empathy, but it is on a spectrum of empathic relatedness that is wide and complex.
Arguably, the listening and receptivity of the community were ready to respond to the message of these books due to seismic shifts in social and productive relations; and the book provided concise language and a set of powerful images to make the point at hand. Though correlation is rarely causation, sometimes correlation is good enough.
No substitute is available for the “magic bullet” of identifying a specific replicateable cause, and such discoveries are rare. Though many people confuse cause and effect (nor am I saying that happens to Keen!), from the point of view of an alliance between empathy, fiction, and social action, it is almost as enlightening and effective to have the literary fiction represent the “signs and portends” of social dynamics that can then become the target of appropriate political action, fund raising, consciousness raising, and social influence. As Keen puts it, “…[reading literary fiction becomes] a sign of one’s empathy and commitment to human principles” (2007: 167). Reading literary fiction – presumably along with political editorials – would be a source and a method of consciousness raising. Still most readers do not look to reading literature as sources for social action in the real world – or at least the evidence-based studies that Keen sites do not show such a result. (2007: 118).
All the casual, easy generalization such as “altruism results in expanded empathy,” “empathy results in expanded altruism,” “reading quality fiction (novels) enhances empathy,” “empathy enhances appreciation of the novel” have significant qualifications, conditions, and counter-examples. Never was it truer, the devil is in the details; and Keen’s work contains a wealth of engaging examples and background on empathy studies. Incidentally, Keen ends her book with some twenty-seven proposals about narrative empathy (2007: 169 – 171).
In discussing the enhanced empathy of authors, who report that their characters come to life in their imaginations, Keen acknowledges the moral ambiguities of the possibilities of empathy for both good and evil. For example, Keen reports that William Pierce (pseudonym: Andrew MacDonald), founder of a white supremacist organization, published The Turner Diaries (1978), containing hateful depictions of blacks, Jews, and gay people. The novel was apparently written with some literary skill. Timothy McVeigh, the bomber of the Federal Building in Oklahoma City (1995), studied this book, and, based on the account in the novel, “emulated its protagonist by building a fertilizer bomb to explode a government building […] made and deployed in a small truck” (Keen 2007: 127).
True, it is highly improbable that the novel by Pierce (MacDonald) caused an upstanding citizen to become a mad bomber. McVeigh was already entangled with murderous levels of prejudice and deviance, and was therefore attracted to the novel. Do not confuse cause and effect; yet the evidence is that this white supremacist novel – and the bomb making parts of it – inspired McVeigh and made him a more dangerous deviant.
Another celebrated example of a novel having alleged causative effects, not mentioned by Keen, in the real world is Goethe’s The Sufferings of Young Werther, in which the broken-hearted hero commits suicide. There really was an epidemic of copycat suicides across Europe in which romantically devastated individuals would jump off of bridges with a copy on the novel in their respective pockets as a kind of suicide note. More good empathy gone bad? Can’t get no satisfaction – or empathy? More likely, individuals who were already suicidal found an expression of their suffering in literary form thanks to the dramatic finesse of Goethe.
I offer a bold statement of that which is hidden in plain view. The hidden variable is the practice of empathy itself. If I read a novel that enrolls me in the practicing prosocial empathic responsiveness to my neighbors, then empathy is expanded. If I read a novel that enrolls me in the practice of white supremacy, then the latter is expanded.
One could argue, though I will dispute the formidable ambiguities, that even white supremacists can be empathic towards other white supremacists. That is the critique of empathy that asserts empathy is too parochial, limited only to the in group, and, as such, a problematic “virtue,” if one at all. The answer is direct. In so far as the white supremacists [and so on] require one conform to a certain prejudiced, humanly devaluing ideology to qualify as the recipient of the practice of empathy, the empathy misfires and fails.
Thus, the debate is joined. The celebrated Self Psychologist and empathy innovator Heinz Kohut, MD, gives the example of the Nazis who equipped their dive bombers with sirens, the better to impart empathic distress in their victims, thus demonstrating their (the Nazis’) subtle “empathic” appreciation of their victims’ feelings. I am tempted to say, “The devil may quote scripture,” and Nazis may try to apply some subset of a description of “empathy.”
Note that Kohut speaks of “fiendish empathy” and the use of empathy for a “hostile purpose” while emphasizing his value neutral definition of empathy as “vicarious introspection” (1981: 529, 580). Nevertheless, the point is well taken that empathy is a powerful phenomenon in all its dimensions and requires careful handling. [For further details see: “On Empathy,” The Search for the Self: Volume 4: Selected Writings of Heinz Kohut 1978-1981, London: Karnac Books, 2011: 525 – 535].
The Nazi applies a kind of entry level emotional contagion or affective transmission of feelings, but the process breaks down at the point of empathic responsiveness. Empathic responsiveness requires a core of acknowledgement and recognition of the other person’s humanity.
But it is plainly evident that the would-be “empathy” of the Nazis (or the white supremacists) misfires and fails in a contradiction. It is a flat-out contradiction to relate authentically to another human being while dehumanizing him or her. Empathy doesn’t work that way. Empathic responsiveness simply does not admit of bombing people or disqualifying them as “less than” or other than human when they plainly are human.
One of the strongest points of Keen’s book is the final chapter on “Contesting Empathy,” in which she cites a long series of objections, qualifications, and doubts about empathy. Failed empathy, false empathy, fake empathy, breakdowns of empathy, and the social construction of the emotions are engaged and deconstructed. Empathy has to run a gauntlet of things that can go wrong with it, though I suggest it emerges out of the backend bruised but still in one piece.
This point is not well-understood in the empathy research literature where break downs of empathy are mischaracterized as features of empathy itself. To blame empathy for its misuse, breakdowns, and misapplications is rather like using the smoke alarm to decide when Thanksgiving turkey is done.
Keen is concerned that the empathy-altruism hypothesis with which she launches her project is left hanging by a thread. If the work of Kohut is to be credited (who, by the way, is not mentioned by Keen), the hypothesis is not likely ever to be validated. Yet if empathy is a practice, not a mere psychological mechanism, then by practicing it, we get better at it in using it to reinforce and expand our shared humanity. Empathy becomes a powerful force in creating a clearing to call forth “the better angels of our nature.” The empathy-altruism hypothesis as an aspirational project, not a social psychology given.
Thus, the really tough question is how does “empathy” as a psychological mechanism relate to “empathy” as a interpersonal process and “empathy” as a practice in relating to people. One starts out talking about empathy as a psychological mechanism, subsumed by a biological mirroring system (even if mirror neurons remain debatable) and invoking identification, projection, and introjection.
Almost immediately one has to give an example of two people having a conversation in which one is feeling and experiencing something that the person may or may not “get” or “understand.” Then one finds oneself immediately discussing the practical considerations of why, in the course of the personal interaction, the empathy succeeded or broke down in a misunderstanding, and how to improve one’s practice of empathy based on experience.
It makes a profound difference from which definition of empathy one begins, though ultimately one has a sense of traversing all the distinctions and simply coming back to enhanced relatedness and understanding of the other person.
One goes in a circle. Readers are attracted to the literary fiction that speaks to their hopes, possibilities, and fears, which, in turn, expands and reinforces their hopes, possibilities, and fears. Then, either by accident or diligent search, readers encounter new forms of writing that change their experiences and perceptions. The writing causes the readers to see existing social structures and ways of relating to other people in new ways. The hermeneutic circle of interpretation? The engaging thing about bringing the hermeneutic circle to empathy is that it provides a series of steps, phases, within which logically to organize the process. Even if ultimately such a hermeneutic circle of empathy falls short of a formal algorithm, one gets a coherent guide against which to succeed or fail and engage in a process of continuous improvement based on experience.
What if a rigorous and critical empathy gave us the data needed to grasp the way to the humanity enhancing actions that need to be taken? The application of empathy would become an imperative guiding our reading and relatedness along with the moral imperatives so important to Keen and Batson. Empathy has not usually functioned as a criteria of literary significance or greatness – until now.
REFERENCES and NOTES
Since Keen published her book in 2007, several peer-reviewed have appeared that support the hypothesis that reading literary fiction expands empathy. These are useful, but do not decisively determine the outcome of the debate; and, obviously, these researchers did not include Pierce (MacAndrews) on their list. A lot of work gets done here by the adjective “literary.” For example:
Bal, P. M , Veltkamp, M. (2013). How Does Fiction Reading Influence Empathy? An Experimental Investigation on the Role of Emotional Transportation. PLoS ONE 8(1): e55341, https://doi.org/10.1371/journal.pone.0055341;
David Comer Kidd, Emanuele Castano. (2013). Reading Literary Fiction Improves Theory of Mind, Science 18 October 2013, Vol. 342, Issue 6156, pp. 377–380, DOI: 10.1126/science.1239918;
Kelly Servick. (2013). Want to Read Minds? Read Good Bookshttps://www.science.org/content/article/want-read-minds-read-good-books [The page # is not available on the web version; but they are short articles.]
The reader may usefully review my blog post on these publications and “reading literary fiction expands empathy”: https://bit.ly/311A2G8
(c) Lou Agosta, PhD and the Chicago Empathy Project
Empathy: Capitalist Tool (Part 1): The Empathy Deficit in Business is Getting Attention
The empathy deficit in business is getting attention
Listen to podcast on Spotify or via Anchor: https://anchor.fm/lou-agosta-phd/episodes/Empathy-Capitalist-Tool-Part-1-The-Empathy-Deficit-in-Business-is-Getting-Attention-e18tlcn
Children and parents get it. Nurses and doctors get it. Teachers and students get it. Couples get it. Consultants and clients get it. Neighbors get it. What about business people? Do they “get it”—that empathy produces results? Practicing empathy is a neglected opportunity in business. The qualities, practices, and behaviors that help a person build a business sometimes work against expanding the person’s empathy.
An executive’s ego, opinion, expertise, and attachment to being right raise the bar on empathizing with others, who may have diverging mind sets. Hard charging entrepreneurs find it hard to let go of their status or set aside the lessons learned as they came up through the ranks. Executives and managers lose touch with the experiences, perceptions, and perspectives of customers, employees, and stake-holders.
The urgent drives out the important. Management effort and time are monopolized responding to competitive pressures, compliance issues, legal challenges, and solving technology problems.[i] For example, according to a report from Businessolver, a human resources and talent consultancy, some 60% of executives believe that their organizations are empathic, whereas 24% of their employees agree.[ii] An empathy deficit?
The stress of operating the business—deadlines, financial issues, staffing crises, software breakdowns, competition, litigation—drive out empathy and a deep appreciation that a commitment to empathy is good for business. The disconnect is substantial between perceptions in the executive suite and in the cubicles of workers and the front line, customer-facing staff.
Ironically, the empathic practices such as the receptive, interpretive, and responsive processes described in detail in this work (as opposed to compassion) are what are most urgently needed in dealing with customer demands, employee crises, negotiations with competitors, vendors, clients, and one’s own budgeting authorities and board, optimally resolving conflicts with reduced cost and impact.
When I ask business leaders what is their budget for empathy training, the response is often a blank stare. Zero. However, when I ask the person what is the budget for expanded teamwork, reduced conflict, enhanced productivity, commitment to organizational goals, taking ownership of outcomes, product and service innovations, then it turns out that budget exists after all. Empathy makes a difference in connecting the dots between business skills and performance. Empathy contributes to results in a powerful way by engaging the staff’s energies and commitments at a fundamental level.
While every business has its own distinct commitments, in many ways, the basic empathy training in business is the same as empathy training in every other context.
The training consists in surfacing and driving out the cynicism, denial, shame, implicit threats, and pressure that many business people experience in their communications. Empathy then spontaneously comes forth and expands the space of possibilities to do business. This does not mean that businesses do not have their own blind spots when it comes to empathy. They do. Therefore, let us take a step back and look at what it is going to take.
An appreciation of the value of empathy to promote breakthrough results often starts in sales. In business, the sales people get it. Developing empathy with customers is good for business.
Even the cynical sales person recognizes that putting oneself in another person’s shoes is a good method of selling them another pair.[iii] The sales person gives the prospect some empathy. Shazam! The customer calls you to close the deal. Wouldn’t it be nice?
Yet the basic idea is straightforward. When the customer appreciates that the sales person is interested in the customer’s requirements, that the sales person is listening, then the customer is likely to open up and candidly share what is stressing him—budget, deadlines, internal politics, market dynamics, or the competition.
When the prospective customer feels that the sales person has understood him, the chance is significantly expanded that he will prefer to purchase the product or service from the empathic representative. Once the customer feels the sales person is listening, the customer will share details about his needs, vulnerabilities, and shortcomings, including those about which he might otherwise be defensive, enabling the sales person to position the product or service as a solution to the perceived problem.
This is not “new news.” In 1964, in the Harvard Business Review—not exactly an obscure, backwater publication—David Mayer and Herbert M. Greenberg called out the two basic qualities that any good sales person must have: empathy and ego drive. These authors define “empathy” as the central ability to feel as other people feel in the context of selling them a product or service.
In Mayer and Greenberg’s article, the sales staff were trained to interrupt themselves when they found that they were reacting defensively to customer complaints, whether legitimate or not, whether solvable or not. Stop—hit the pause button before responding. Instead of reacting to the complaint, the sales person was trained to “get” the complaint and to communicate back to the customer that he “got it,” namely, that the customer was upset (or whatever the customer was self-expressed about).
The sales person was trained to acknowledge that a breakdown had occurred. Key term: breakdown. The sales person was trained to acknowledge the complaint by calling it out: “This is a break down!” Even if the customer is inaccurate or wrong in his complaint about some detail, the customer is always—the customer.
By definition, the breakdown in the product or service occurs against the expectation of customer satisfaction. The relationship between the buyer and seller is itself in breakdown against the expectation of satisfaction. This does not rule out the possibility that additional training is needed on the part of the customer about product features or the service level agreement; but such training is substantially different from a defensive reaction.
The next step is repairing, fixing, or at least managing the cause of the complaint: the respondent then solicits additional feedback and details as to the complaint, i.e., what went wrong. The empathic response includes what one is going to do about the breakdown and by when.
The committed listening, that is, empathy, creates a clearing for communication, improving the sales process, and restoring authenticity to the relationship when integrity has gone missing. While there are no guarantees, customers treated in such a way tend to stick. Repeat business, maximizing revenue over the lifetime of the relationship, is one of the outcomes. [iv]
The empathic leader meets “economic man”
Development Dimensions, Intl., (DDI) identifies empathy as one of the critical success factors in executive leadership. One of the leading talent development corporations in the market, DDI’s report on High Resolution Leadership identifies empathy as an emotional quotient (EQ) “anchor skill.”
Empathy provides the foundation for interpersonal leadership skills such as developing subordinates, building the consensus for action, encouraging engagement, supporting self-esteem, and taking responsibility.[v]
In the DDI study, listening and responding with empathy were demonstrated by 40% of executives profiled (as opposed to 71% whodemonstrated taking responsibility or 54% who demonstrated building agreement on actions to take).
The conclusion is that, as regards empathy, the majority of leaders have room for expanding their performance. The good news is that, using interventions designed to expand empathy, the empathy skills needed to drive business results are within reach. [vi]
Thus, the empathy deficit in business is getting attention. Empathy is moving to the foreground. The role and contribution of empathy to business results is penetrating the awareness of leaders, managers, staff, and stake-holders.
Closely related to the challenge of closing the empathy deficit in business is the challenge that “economic man” is significantly different than man as such. Let’s define our terms.
The person who conducts transactions in the market is defined in business school as economic man—homo economicus. The latter is significantly different than man, the human being as such. The person (man) in the economic theory is rational, selfish, and her or his tastes do not change.
Business practices assume the organization is engaging with customers, employees, stake-holders, and leaders who fit the model of economic man. Human beings, on the other hand, do not. Most people in business do not know anyone who fits the description of economic man. Why then are we so busy trying to do business with him when he does not even exist?
Unlike the person described in economics in business schools, humans are limited in their reasonableness. Humans are diverse and inconsistent in their preferences. Humans are even limited in their selfishness, being generous and compassionate in unpredictable ways.
The issue? Nobel Prize winning economist Gary Becker’s rational choice theory (preference theory) in economics has been extended to many other aspects of life. Becker’s rational choice theory has been extended to areas as diverse as marriage, crime, and discrimination.
Generalizations from rational choice theory to the social sciences at large have been a growth industry in the social sciences. From the rich mixture of inconsistencies and contradictions that most people really are in life, the human being was translated into a function of rational, self-interested, and allegedly consistent preferences. The human as such has been simplified and redescribed as a rational, calculating engine of human behavior.[vii]
People are supposed to be consistent in their preferences and tastes. People are supposed to be logical and consistently obey the rules. But finding counter-examples is easy.
For example, if a person prefers coffee to hot chocolate and the person prefers hot chocolate to tea, then, according to this logic, the person is supposed to prefer coffee to tea. [Think: coffee > hot chocolate > tea; therefore, coffee > tea, according to the transitive rule, in which “>” means “prefers.”] But, no, it doesn’t work that way. Given all these personal preferences as indicated, the person still chooses tea instead of coffee. The person just prefers tea to coffee. The individual is from London!
Nothing inherently illogical exists in preferring coffee to hot chocolate and tea to coffee while also preferring hot chocolate to tea. Nothing unless one insists on making a dynamic network into a transitive sequence. So much for rational choice theory.
The lesson? Empathy as well as logic are required to understand decision making. Without allowing for the possibility of empathy, economics produces some strange results. People are not natural born statisticians, logicians, or gamblers, though the discipline of economics sometimes seems to assume so.
Still, testing a person’s decisions and preferences using probabilities, bets, and lotteries is an engaging exercise, and nothing is wrong in doing so. However, unless one also adds empathy to the mixture of economics and logic one misses something essential—the person!
Now, I apologize in advance to the reader for the technical terms, but in economics the chance of winning a bet is expressed as an “expected utility.” “Expected utility” is technical talk for “satisfaction” or “happiness.” (But nothing more than arithmetic is needed to get this. )
For example, in economics the expected utility of a 10% chance of winning a million dollars is $100K [.10 x 1,000,000 = 100,000] [note: K = 1,000]. If Jack and Jill both end up with a million dollars, they should enjoy the same expected utility, no? Remember, Jack and Jill are supposed to be rational, selfish, and consistent in their preferences. Now consider a counter-example:
Today Jack and Jill each have a million dollars.
Yesterday Jack had zero and Jill had two million dollars.
Are they equally happy? (Do they have the same utility?)
You do not need an advanced degree to know that today Jack is very happy and Jill is in despair. Yesterday Jack had zero; now he has a million dollars. Hurrah! Yesterday Jill had two million dollars; now she has only one million. Ouch!
We must be able to put our ourselves in the shoes of Jack and Jill and get a sense of their expectations. Sounds familiar?
These expectations, in turn, constrain their experience of satisfaction (i.e., happiness). To grasp the outcome in terms of their individual experiences, we need an empathic anchor or reference point in their expectations from which they begin. Empathy gives us access to an anchor point in their respective experiences.
Our empathy shows that outcomes are linked to feelings about the changes of one’s wealth rather than to states of wealth. The experience of value depends on the history of one’s wealth, not only the current state of it.
Yet another bold empathy lesson: People are strongly influenced by hope and fear. Empathy indicates that people attach values to gains and losses, and these are weighted differently than logical probabilities in decision making. This is not just saying that people are irrational, though that may be true enough at times, too. This says that people (and their behavior) frequently do not conform to the pattern of rationality, selfishness, and consistency in preferences.
Still, the matter is not hopeless for those committed to pattern matching in economics. People are frequently surprising, but sometimes in predictable ways. People are sometimes inconsistent, but one can sometimes predict those inconsistencies if one learns one’s empathy lessons.[viii] For example:
(1) People are risk averse due to fear of disappointment and regret. The empathy lesson is that people try to avoid risks even in situations where taking a risk is a good bet. “A good bet” is determined according to the probability calculation.
Consider: if a person had a 90% probability of winning a million dollars, he ought to accept $900K as a “sure thing” settlement, which settlement is logically equivalent to a 90% probability of winning the million dollars [.9 x 1,000K = 900K]. The 10% probability of not winning is an unlikely outcome, but still possible. The “unlikely outcome” often determines the result.
For example, law suits in cases of accidents and contract disputes produce settlements in trial law indicating that people will “settle for” $800K or even $750K for the possibility of knowing the outcome with certainty. For most people that is still a lot of money, and the possibility of having to live with the regret of missing the pay-off due to an unlikely outcome gets most people out of their comfort zone. They decide to settle.
Empathic receptivity to the possibility of disappointment and regret may usefully “override” the rational, self-interested, and consistent preferences that the purely economic person brings to the negotiations.
(2) People are risk seeking in the hope of getting an even larger gain instead of accepting a modest settlement.
This is why people bet on the state lottery where the chance of winning is vanishingly small. Such a bet is illogical, but common. We need expanded empathy to get a clue what is going on here.
The empathy lesson indicates that people are not buying a chance to win a big pot of money. Rather people are buying a chance to dream of the possibility of winning the big jackpot. “We are such stuff as dreams are made of,” said Shakespeare. The value is in the dreaming, that is, precisely in the possibility of the big jackpot, not the jackpot itself. That such a dream would more likely be the dream of a poor person rather than an affluent one is a further problem that invites attention.
If one looked rationally at the odds, one would not buy the ticket. No way. Clearly lotteries are popular, especially with the poor and “have nots.” The possibility of escaping from poverty is being manipulated in a cynical way by the establishment, and we citizens have all become “addicted” to the revenue stream.
The lottery budget and effort would be better devoted to job training and instruction in basic financial management, except now lotteries have become a source of revenue for local government and education. This is a breakdown in empathic understanding, which gives us our possibilities. It is hard not to become a tad cynical in considering that the poor are paying for education through lottery revenue, though they are often unprepared to benefit from or hindered from accessing the educational opportunity.
(3) People are risk seeking in the hope of avoiding a loss in situations in which simply stopping a project altogether would enable cutting their losses (rather than incurring additional likely losses). Defeat is difficult to accept. The empathy lesson is that people are attached to an ideal, in this case a losing cause, for reasons extending from perseverance, egoism, greed, risk aversion, fear of the unknown, all the way to idealism, romance, blind hope, and just plain stubbornness.
People (and businesses) facing a bad outcome manage to turn a survivable (but painful) failure into a complete meltdown. Desperate gambles often make a bad situation worse in exchange for a small hope of avoiding the loss at all. Businesses, individuals, and even countries, continue to expend resources long after they should blow the bugle, lower the flag, and leave, implementing an orderly retreat. Instead people (and organizations) persist in a lost cause until a rout becomes inevitable.
Business accounting teaches the basic idea of a “sunk cost.” Suppose Octopus, Inc., (OI) is building a new software system for $100 million dollars. OI has already spent $150 million. The project is over-budget. It is estimated to take another $55 million to complete the job. Suppose further that evidence of a new, breakthrough technology really exists. It would enable OI to develop the system from scratch for $25 million. What should OI do? The money already spent is a “sunk cost.” It should not influence the decision. Given the evidence that the new technology really works, the OI project leader should throw away the over-budget system and build the new one from scratch, spending $25 million and saving $30 million against the projected completion cost of the project. However, that is not what most project leaders would do.
Due to a sense of ownership of the over-budget project and a fear of the unknown in engaging the new technology, many project leaders double down on the investment in a losing proposition. In a breakdown of empathic interpretation, they continue to project their hopes and fears onto the old technology and, as the saying goes, throw good money after bad.
(4) People are risk averse due to a fear of a large loss and may rationally and usefully bet on a small chance of (avoiding) a large loss. This is why people buy insurance. The empathy lesson is that people are not merely buying protection against an unlikely disaster; they are buying peace of mind, the ability to get a good night’s sleep. If the negative event would have catastrophic consequences, creating a risk pool, in which everyone participates, spreading the risk in a manageable way, makes compelling sense. Note that certain risks such as war and civil insurrection (or a giant asteroid hitting the earth) are uninsurable. Insurance is a calculation, not a gamble against undefined odds. In general, the insurable risk must relate to individuals or subgroups and the occurrence of the risk should not destroy the infrastructure of the entire community, which needs to be intact to cover the insured risk.
Insurance was a brilliant business innovation that emerged at about the time of the European Renaissance as traders in the Netherlands—those frugal Dutch—were sending valuable but fragile ships to fetch precious cargo in far away lands. The risks and rewards were great. How to even out the odds? Insurance was born.
In our own time, one can see the irrationality, the unempathic response, and gaming of the system by special interests in health insurance in the USA where attempts were made to exclude the sickest people from the insurance pool through penalties for preexisting illnesses, combined with charging monopoly rents to the healthiest participants.
Insurance is often a “good bet” when an outcome that is highly unlikely but catastrophic can be managed by everyone (or a large group) incurring a small cost to spread the risk. But how to get everyone at risk into the pool? When told that people have no health insurance, some politicians are supposed to have said: “Let them pay cash!” In another context, in one the most spectacular breakdowns in empathic responsiveness in modern European political history, the French Queen, Marie Antoinette, was told that the people had no bread, and she is supposed to have said: “Let them eat cake!” Same idea?
Saying that the purpose of business is to make money is like saying the purpose of life is to breathe. Keep breathing—and make money—by all means. But the purpose of life is to find satisfaction in one’s work, raise a family, write the great American novel (it’s good work if you can get it!), experience one’s efforts as contributing to the community and making a difference.
Likewise with business. Business is about delivering human value and satisfying human demands and goals, whether nutrition, housing, transportation, communication, waste disposal, health, risk management, education, entertainment, and so on. Even luxury and conspicuous consumption are human values, which show up as market demands.
In conclusion, business people “get it”—empathy is good for business. Profit is a result of business strategy, implementation, and operations, not “the why” that motivates commercial enterprise. And if profit shows up that way (as the “the why”), then you can be sure that, with the possible exception of index derivative hedging, it is a caricature of business and a limiting factor. Business prospers or fails based on its value chain and commitment to delivering value for clients and consumers. However, as noted, some of the things that make people good at business make people relatively poor empathizers.
Business leaders lose contact with what clients and consumers are experiencing as the leaders get entangled in solving legal issues, reacting to the competition, or implementing the technologies required to sustain operations. Yet empathy is never needed more than when it seems there is no time or place for it. This is a challenge to be engaged and overcome.
What to do about it? Practice expanded empathy. Empathy is on the critical path to serving customers, segmenting markets, positioning products (and substitutes), psyching out the competition—not exactly empathy but close enough?—building teams and being a leader who actually has followers. Empathy makes the difference for contributors to the enterprise at all levels between banging on a rock with a hammer and building a cathedral. The motions are the same. When the application of empathy exposes and strengthens the foundation of community, then expanding empathy becomes synonymous with expanding the business. Building customer communities, building stakeholder communities, building teams that work, are the basis for product innovation, brand loyalty, employee commitment, satisfied service level agreements, and sustained or growing market share. Can revenue be far behind? Sometimes leaders don’t need more data, leaders need expanded empathy, though ultimately both are on the path to satisfied buyers, employees, and stakeholders. If the product or service is wrappered in empathy, has an empathic component as part of the service level agreement, gets traction in the market, and beats the competition’s less empathic offering, then we have the ultimate validation of empathy. We do not just have empathy. We have empathy Capitalist Tool!
Notes
[i] Katja Battarbee, Jane Fulton Suri, and Suzanne Gibbs Howard. (2012). Empathy on the edge: Scaling and sustaining a human-centered approach in the evolving practice of design, IDEO:
http://liphtml5.com/gqbv/uknt/basic [checked on 03/31/2017].
[ii] William Gentry. (2016). Rewards multiply with workplace empathy, Businessolver: http:// http://www.washingtonpost.com/sf/brand-connect/businessolver/rewards-multiply-with-workplace-empathy/ [checked on 03/31/2017].
[iii] Roman Krznaric. (2014). Empathy: Why It Matters, and How to Get It. New York: Perigree Book (Penguin): 120.
[iv] C.W. Von Bergen, Jr. and Robert E. Shealy. (1982). How’s your empathy? Training and Development Journal, November 1982: 22–28: http://homepages.se.edu/cvonbergen/files/2012/11/Hows-Your-Empathy.pdf [checked on 03/31/2017].
[v] Research Staff. (2016). High Resolution Leadership, Data Dimensions, Intl.: http://insight. ddiworld.com/High-Resolution-Leadership [checked on 03/31/2017].
[vi] William Gentry, Todd J. Weber, Golnaz Sadri. (2007). Empathy in the workplace: A tool for effective leadership, http://www.ccl.org/wp-content/uploads/2015/04/EmpathyInTheWorkplace.pdf [checked on 03/31/2017].
[vii] Bernard E. Harcourt. (2015). Exposed: Desire and Disobedience in the Digital Age. Cambridge, MA: Harvard University Press.
[viii] Daniel Kahneman. (2011). Thinking, Fast and Slow. New York: Farrar, Straus, and Giroux.
(c) Lou Agosta, PhD and the Chicago Empathy Project
Empathy versus bullying: Part 3: Recommendations for students, parents, teachers and administrators
Listen to podcast on Spotify (via Anchor): https://anchor.fm/lou-agosta-phd/episodes/Empathy-versus-Bullying-Part-3-Recommendations-for-students–parents–and-educators-e17j1ts
Bullying: Recommendations for students
If one is being bullied, some guidelines are useful.; though no single, easy answer is available.
[Note: even though these recommendations directly address the “student,” they are intended to provide guidance to the parent or responsible adult on how he or she is to address the student regarding bullying. They are intended to inform the grown up, adult’s speaking and listening in the matter of bullying as the grown up engages with their student.]
First, these recommendations are about getting back your power—or at least some of your power—in the face of bullying. Sometimes that looks like making a tactical retreat, much as one might dislike doing so, in order to reestablish boundaries and integrity. The idea is to de-escalate the potential confrontation. What de-escalation looks like is different according to the situation.
Second, this is not happening to you—the target of bullying—because you did anything wrong. Stop the negative self-talk (devaluing comments directed at oneself) about being to blame for the bad behavior of bullies. Such negative self-talk results in two problems, the bullying and your own negative self-talk.
Previously there was only one problem, the bullying. Now two problems exist, the bulling and the negative self-talk. Reduce the problems by 50%; stop the negative self-talk. If you cannot seem to stop the negative self-talk, then get help from a parent or professional with doing so.
Many different kinds of bullies exist—see the above typology—and it is not your job to be the bully’s therapist or policeman.
There is probably no reply to the bully that is so powerful that the bully cannot transform it by using a sing-song, condescending tone of voice.
Even if one says: “Thank you for respecting my privacy,” a statement that makes a great quotation in any subsequent police or administrative report, the risk is that the reply is going to come back at you like yet another confrontation. It might be worth a try, but no guarantees.
The bully is behaving the way he does to “get a rise” out of the target. The intention is to make the target upset. That is a “pay off” for the bully. That is not to say that one should not shout back if shouted at or push back if one is pushed. That is a judgment call based on the situation and one’s sense that fighting back—otherwise know as “self defense”—may make a positive difference in establishing or maintaining a boundary.
However, if one is out-numbered or the bully is physically larger and one’s power is diminished, engaging the bully in a back-and-forth exchange is not going to work. If one can maintain some measure of composure or equilibrium, then the process of escalation on the part of the bully may be short-circuited or at least moderated. The bully is “getting off” on upsetting the target, so, tactically speaking, being boring to the bully is a valid defense. You will be “less fun” for the bully, and he will move on to the next target.
Another thing that is done—and is potentially life saving—is to keep a “bully log,” noting in writing, once one escapes, the occasion on which one was bullied and what exactly was said or done. In the case of cyber bullying, this includes print outs, with URLs and time stamps, or screen shots of devaluing comments from email, Facebook, social media, or text messages.
I know, I know. The last thing that a kid stressed out by bullying wants to think about is documenting what is happening precisely so that one can escalate and get one’s power back. But that is what is required. One may prefer to forget about it all, but keeping a log with dates and times and names (or descriptions if one does not know the name) and what exactly was said or done, is going to be an important part of getting one’s power back in the face of bullying.
Civic and spiritual leaders such as Gandhi and Martin Luther King have famously pointed out that “no one can diminish you without your consent.” That remains true; and it is always a good reminder to oneself in the face of bullying. However, King and his followers actively trained and role-played non-violent resistance prior to engaging in demonstrations, civic actions, marches, protests, and sits-ins, in which they confronted bullying, hostility, and out-and-out violence.
Civil rights activists practiced with colleagues, who pretended to be racists, hurling insults and ketchup at the would-be demonstrators in role playing. In turn, the would-be demonstrators practiced not responding with counter-aggression; and all this prior to their actually engaging in anti-segregation sit ins, public protests, civil disobedience, and so on.
One should not have to undertake training in non-violent resistance in order to survive the ride on the bus to school or the school lunch room, and the fact that we are now discussing such a scenario means that something has already gone seriously off the rails. Attempting to transform a culture of segregation and colonialism as King and Gandhi did—or a culture of bullying—is not for the faint of heart.
A group of middle or high school kids are not the KKK or the British Empire (though they may seem like it at times), and such kids cannot be forced to include an “outsider” when they really decide not to be inclusive. Thus, the coaching to the outsider is to keep looking for a group that is welcoming. Once again, it takes courage—and a support system—and is always easier said than done.
People need friends, and, for people in middle and high school, relating to friends is an important part of the fun. It is a part of growing up and the non-academic learning that occurs. If you are with a group of people—also called one’s “peers”—and their behavior and speech towards you leaves you feeling “less than” or “upset,” then you may need to look at your understanding of what is a friend. If your inquiry to your “friends” as to what is really going on seems to elicit more of the same upsetting and “less than” behavior—then you need to re-examine their status as “friends.” I hope you will not shoot the messenger: it is time to move on and seek friendlier friends.
One bullied LGBT teen made a difference by trying to join a Gay-Straight Alliance group activity at his high school. But there was one catch. Before he could join the alliance, he had to create it. It became a significant project, and a path to engagement for him and numerous fellow students both gay and straight. Never underestimate the power of one person with the courage to stand up and say “Enough—there’s got to be a better way!”
Friends may argue. Friends may disagree. Friends may engage in drama over boy or girl friends. Friends may even decide to stop being friends and go their separate ways. But if one finds so-called “friends” treating one like an outsider, using de-valuing language towards one, or being mischievous in ways that are cruel, mean, or aggressive, then it is time to find new friends. If one’s peer group lets one down, then it is time to seek a new peer group. Once again, this is not easy to do when one is struggling against bullying. However, if one is unable to take action in the direction of finding new relationships because one is so paralyzed by the upset, then it may be because one is anxious or depressed, and the intervention of a caring third party is warranted. But where to turn?
If you have a good relationship with one or both parents, that is a good place to start. Here “good relationship” means that you can talk with him or her. It means the parent has the ability to empathize with your predicament and listen to your concerns. It also means you are not going to come away from the conversation feeling bullied. Older siblings can also be useful if one has a good relationship.
The idea is not to have a grown up “fix” the problem for you, but to find a “trusted advisor” to work with you on what can be done to get back your power—or at least some of it—in the face of bullying. Though the analogy is imperfect, this is a tad like getting tutoring in geometry or science. Do not expect the tutor to do your homework for you; but together you work to acquire the skills, so you can not only survive the lunchroom or school bus ride, but also even have fun and prosper.
If you do not have the kind of empathic relationship with a parent that makes you think the parent can help to improve the situation, then look for a trusted teacher at school with whom one has a relationship. (But see the caution below about teachers and staff being school-bullying-mandated reporters.) Once again, this should be someone who you believe will listen to you—use her or his empathy to appreciate you—and work with you to improve the situation. If neither your parents nor a trusted teacher at school can be mobilized to intervene, then you should look for someone in the community such as a coach at the art or sports center, a pastor at church, or coordinator of the LGBT group in the community with whom you enjoy a relationship of empathy and trust.
If you are being harassed online, request that the web site take down the content, since the harassing comments violent the rules of most web sites. If the site is Facebook, report the abuse immediately via the dropdown item “this picture is of me and I don’t like it” [or words to that effect]. Facebook says that it is committed to taking the word of the reporter (you) about harassing comments. Print out the cruel or mean content or make a screen shot. Put all such stuff in a folder. You need to show others in authority what is happening. It is almost never useful to respond to the perpetrator. If you find yourself compulsively checking back for mean content, take a time out. Power down. Pull the plug. It is not worth it. It might be better to give online activity a break and drop out for awhile. Good friends will be able to reach you by phone or in person.
Another word of caution is needed. If you approach someone in school—a teacher or member of the staff—then this person may be required by law to report the bullying to the school administration. This might be okay if the school has a program in place to deal with bullying. This is also where your written record detailing bullying that has occurred over the past period can be useful. I wish I could say that this would not result in further bullying with accusations of being a “snitch” occurring. But the risk of escalation is real and must be considered prior to taking action.
If the reputation of the school is one of having a culture that seems to permit a certain amount of aggression and discourtesy, whether towards teachers or one’s fellow students, then the risk expands. Retaliation on the part of bullies for complaints about their bullying can become as significant an issue as the bullying itself.
Once the school administration is involved, the process can take on a life of its own. The administration must (is mandated to) open an investigation, and the requirement to gather evidence of bullying can make you feel like you are inside the “hall of mirrors” at the carnival without, however, anyone having any fun.
Grown ups are notoriously unable to distinguish adolescent drama from out-and-out bullying. This is sometimes due to grown ups’ lack of empathy, but not always. If the tweens and adolescents cannot tell these apart, why should the grown ups necessarily be able to? What seemed open-and-shut to the target of bullying can take on disturbing nuances once people are interviewed “on the record.”
Trying to sort out a bullying report can become an exercise in forensic investigation with conflicting testimony full of “he said” and “she said.” Are witnesses denying an alleged episode of bullying—note the legalese “alleged” shows up—because they don’t want to be regarded as “snitches” or because the episode never occurred?
The school system itself—no matter how empathic and well-intentioned—can seem to work unwittingly to punish all participants—or at least use all the time and effort of all implicated in a given incident in filling out forms, processes, procedures, and attending meetings. The process of determining what happened = x has now become something to survive—a potential breakdown in empathy and a breakdown in community. Ready or not, one has matriculated in the “college of hard knocks.”
However, if the student is being physically assaulted or harassed to the point where the student’s school work is suffering (grades and so on), then it is best to “bite the bullet,” fill out the formal report—including the police report if appropriate—try to take charge of the escalation, share the suffering, and learn the lesson in community building.
No one should have to suffer in isolation in the face of bullying. Part of the abuse consists precisely in the bully’s attempt to isolate the target. So the best outcomes are those in which one is able to take action to break out of one’s isolation: finding new and welcoming friends, martial arts lessons, founding a gay-straight alliance at the school, chess or science club, and so on. Once again, this is easier said than done, but it must be both said and done.
If you are someone who is caught up in drama and you are tempted to bully someone, it is time to take a time out. Take a look at your own behavior. Do you really want to be known as someone who is mean or a bully? While “put downs” or “one liners” might seem like auditioning for a role in a reality television show, hit the pause button. There are better ways of getting into show business. Go out for theatre or sign up for an improvisation class. All the world is a stage, and an important part of the training for theatre—and for success in life—is role playing. Indeed acting is precisely role playing. Try taking a walk in the other person’s shoes. There are other, better shoes—and choices—than to bully or be bullied.
Bullying: Recommendations for parents
If your child comes to you with an upset about bullying or you see that she or he is upset about something and the story sounds like bullying, then what should a parent do?
This is where empathy goes a long way. Start by listening. Your job as a parent is to support your child and to help your child regulate the child’s feelings and behavior. Your job is to help the child regain an emotional equilibrium in the face of life’s vicissitudes, including bullying.
Parenting is about setting boundaries. Empathy is about navigating boundaries, and bullying about violating boundaries. Therefore, empathy is about restoring boundaries in the face of bullying.
Be empathically receptive and responsive: “That’s really gotta be a concern.” “Try to tell me exactly what happened.” “Then what happened?” “Say more about that.” “Okay, but help me understand.” “He said what?!” Ask about the details in a concerned, empathic way. “Johnny is a jerk” may be true; but it is an interpretation. That Johnny said “You are a loser” while pointing at his forehead with his fingers in the shape of an “L” is a report of a devaluing comment. Do not be dismissive. It’s not “nothing.” Note it. Be concerned. Avoid finger wagging or moralizing. Though you are obviously “on the side” of your child, do not assume she or he is an angel. Likewise, if the child is known to have a “devilish” streak, do not assume he or she is the devil. A single example is not bullying in itself, but repeated instances start to form a pattern of concern.
One word of caution to parents at this point. One issue that should not be overlooked is how the adult is inevitably confronted with his or her own fate as a child in the face of bullying. In short, if you had a bad experience in bullying that is still unintegrated as an adult, it is going to be there when your child comes to you. If you have unresolved issues around bullying in your own history, when your child comes to you about bullying, a challenging situation becomes all the more challenging for you. You have to distinguish the child’s problem from your own in order to do your job. As a parent, your priority is to solve the child’s problem, not your own.
Now this does not mean the parent has precipitously to go back into therapy (though nothing is wrong with that as such), but that one must be prepared to identify and use one’s own experiences around bullying as a resource. These experiences, long past, will come up. Promise. This is where parental peer support can be essential. Consult with other parents with whom you have a relationship of empathy and trust. It is crucial this be a person to whom one can relate without moralizing or finger pointing.
If one does have an unresolved issue around bullying, then acknowledge it, so that one can gain some distance and objectivity about bullying today. In a deep sense, bullying and human aggression have not changed, though they now have online technology at their disposal; but parenting norms, schools, school administrators, and community standards have shifted significantly since Baby Boomers and even Gen-Xers have struggled with bullying in a different world.
If, when you were a kid, the guidance from your parent was “just hit him back,” and it worked, then you are going to be inclined to provide such guidance. If, when you were a kid, you told his mom about his bullying behavior, and it worked (as unlikely as that may seem), then your initial inclination is going to be to provide such advice. Even if you wished that you had “just hit him back,” but were not able to do so, you are also going to be inclined to provide such guidance. You see the dilemma?
Our empathy for our children in the here and now is a function of our own fate as a child in what was (and is) not always the most empathic of worlds. If one is at a party for five year olds, tweens, or adolescents, then one is inevitably going to be present to one’s own experiences as a five year old, tween, or adolescent. That is a risk and an opportunity. Such experiences from one’s own childhood or teen years can be a useful resource and should not be overlooked. However, such experiences of surviving bullying are most likely to make a positive difference within the context of an empathic listening to the child currently being bullied, not the context the parent had to overcome long ago. [i]
The point is to appreciate the distinction between your own experiences and those of your child. An outgoing or extroverted parent may have a shy or introverted child—or vice versa. Yes, certain kinds of bullying are such that a child may properly be expected to handle them on his or her own. However, if the child who used to enjoy school now dreads it, if grades are suffering, or if a once flourishing child is now floundering, and it is not clear what is going on, then intervention is required.
A substantial part of the challenge for the parent is to re-create the context on the school bus, at school, in the lunchroom, or on the sports field. What seems at first to be an open-and-shut case of meanness or cruelty can turn out to be a complex example of drama, pseudo-sibling rivalry, or bad manners. Debates quickly emerge about “Who started it!?” or “he said” and “she said.” Try to determine who said what to whom and then what happened. You may quickly find yourself asking, “Is there a single fact here?” This, however, does not mean that bullying did not occur. As a parent, you want to document what you have learned, and you want to keep open the lines of communication with your child. Is there a pattern?
In order to be useful in supporting your child, you must have a thorough grasp of what is going on. Get the entire narrative. If what is happening really is bullying, you will want to be as specific as possible in order to make a report to the authorities if the problem persists.
This is where the difference between handing the child a fish and teaching him or her how to fish is the lesson. Even if the student is an adolescent, the student’s request may be to “fix” the problem and make the bully go away. Wouldn’t it be nice? Rarely is that practical. If the bullying is occurring on the way to or from school, and if one can take a different bus or route, by all means, do so. Band-Aids have their uses. Tourniquets are essential. Buy some time to figure out what is really happening.
The tough job of parenting occurs at four levels: (1) providing guidance to one’s student on how to fend for oneself; (2) providing explicit training in self-defense or assertiveness if the student can be enrolled in the value of doing so; (3) reaching out to the parents of the alleged bully if there is any chance they are responsive people, who are able to have a civil conversation; (4) intervening with school authorities (or law enforcement) as a last resort if no other solution can be found.
(1) Share with the student the above-cited coaching in “Recommendations for Students” about the dynamics of bullying. Even if you have reason to believe that your child has been provocative and is engaging in drama, begin by asking, “What happened?” “Who said what to whom?” “What happened next?“ Do not begin by asking, “What did you do to cause this?” That can seem like blaming the victim. Do not be dismissive. Trust—but verify empathically.
Providing empathy means that one should provide examples of proper behavior on the part of “friends” and peers; friends do not use devaluing, hurtful, bad language or engage in aggression against one another; and broach the difficult subject that maybe one needs to find new friends or a suitable, different, extra-curricular activity if one is being harassed. One should provide assurances to the child, who is blaming himself, that the child did not do anything to deserve such treatment.
(2) Time was when “bullying” meant physical aggression. “Sticks and stones may break my bones, but names will never hurt me.” We now know that devaluing names, too, are hurtful. This is especially so when the name calling occurs persistently across different environments—at school, on the bus, online after school, and so on. I know—I know. Why is it that parenting usually seems to require ever-increasing commitments rather than less? Yet intervention on the part of the grown ups is important., especially if the meanness is escalating.
If a student, who is being physically assaulted, sees value in boxing or Asian martial arts lessons, the parent may pick up the extra expense and effort of chauffeuring him or her. It may be worth it. Self defense remains a fundamental right.
However, if the individual is up against a group or the size differential is substantial, such lessons might be good for one’s self-esteem (and the value of such a contribution is not to be underestimated), but it is of limited practical value in surviving an altercation. For some shy or socially awkward kids explicit training in social assertiveness is useful.
(3) If one is part of a community where one has communications with other parents, then it may be worth the risk to reach out to the other parents. It is important to do so in a way that does not land like an incoming accusation or reproach. That such a conversation would initially be uncomfortable is no reason not to try.
If you can work with the other parents, it provides an example to all the children of how to resolve conflict in a mature, adult way that benefits all involved. Such a lesson is worth its weight in gold—or at least an associate’s degree in counseling. However, if the parent turns out to be troubled or a part of the problem, then one has perhaps discovered the source of the bully’s misbehavior. One has to move on. Encourage one’s child to leave alone a “friend” who is making his life miserable.
(4) If one has exhausted individual coaching to the child or outreach to other parents, and one still has concerns about the child’s safety or the impact of bullying on a child’s academic results, then it is necessary to approach the school authorities. Remember that these may be harried individuals.
School authorities already have a long list of academic, administrative, and educational responsibilities. The state legislature has just mandated compliance with rules that schools take on the task of managing and improving a situation in which 10% of a school population (say) of 1,000 students is either a bully or a target of bullying over a given period of time. A budget increase to support the mandate is still pending, meaning doing more with less is again demanded.
A parent may have a right to stand up in a school board meeting and express concern or even accuse officials of being indifferent to bullying.
However, it does put one in mind of Dale Carnegie’s dictum: if you want to gather honey, do not kick over the bee’s nest.
Rather identify an educator or administrator who has the empathy to hear your concern about your child’s emotional and academic well-being and its urgency. In a time sensitive situation, specific steps can be taken such as allowing the child to keep a cell phone with him at all times to call for help; a designated safe room (say next to the nurse’s office) that the child can go to in case he feels unsafe; a special hall pass or permission to arrive two minutes before class to avoid the bully; or assigning a grown up to accompany her or him through the hallway. It is important that all the relevant teachers and staff know about this or it will just become another breakdown, punishing the victim as the phone gets confiscated, and so on.
In the case of cyber-bullying of tweens, parents may appropriately have access to the online passwords. Parents may usefully know what sites the children are visiting. Even if one has a phobia for technology, it is imperative for the parents of kids using computers to have a minimum of computer literacy to supervise the kids’ involvement with electronic media. It is a tad stealthy—but I would not rule it out—to have the child train you with her email or Facebook account, and then use what you have learned to monitor theirs.
You would not simply give the kids the car keys and tell them, “Hey, keep in touch!” Funny. The Internet is different than the open road, but hazards and risks exist in abundance in cyberspace, too. Since no parent has enough time to monitor the totality of anyone’s online activity—it would be crazy to try—start out like the wise teacher who begins with strictness but eases up thereafter based on proper behavior and feedback.
Manage by exception. Trust but verify. If spending time engaging online becomes an upset to the child, then an empathic inquiry as to what is happening is needed. Expectations for online behavior should be made clear: Just as one would not use devaluing language, ethnic or racial insults in person, so too one should not do so online. If one is the target of such behavior, then it must be documented, monitored, and neutralized through appropriate interventions.
Why is it that people forget you can turn off the computer or not go to certain sites? Parents’ good examples of laying aside electronic devices and relating in person to other persons speak volumes to kids. So does any behavior that demonstrates a parent’s commitment to drama or using social media to drive personal conflicts. Business people and politicians now have a rule about email and comments on social networks (even if they do not always follow their own good guidance): Write every electronic comment or communication so that it could be published on the front page of the Wall Street Journal without creating an embarrassment. The reason? Because the communication will eventually migrate there! This is an essential rule of thumb going forward.
Such is especially the case after the US election of 2016 where a seemingly endless stream of hacked emails—containing ambiguous and devaluing comments about the sender’s colleagues—got published periodically. In some cases, no hacking was required, since the candidate published the comments intentionally using Twitter.
As this book is being published, reports are emerging that Russia—you know, the sovereign state or a clandestine unit thereof—has attempted to influence the US 2016 election by purchasing ads on social media that attempted to aggravate racial, social, and economic divisions, thereby driving voters towards one Presidential candidate rather than the other.[ii] A lesson for us all? The ability to think critically and for oneself has always been an essential foundation of any democracy or any middle school kid’s emotional well-being. Now more than ever.
There is also a rule—at the level of Sir Isaac Newton’s ironclad Laws of Motion—that naked or compromising photos taken by a person migrate inevitably in the direction of social media. So don’t take any; and delete any that might already exist now—before it’s too late!
The expectations of privacy are such that online communications can no longer reasonably be expected to be private. Perhaps they ought to be private. Perhaps the 4th Amendment to the US Constitution against unreasonable search and seizure still holds sway in courts and halls of justice in the USA. I hope it does. I believe it does. But cyberspace just does not work that way any more. Facebook is designed so that people are given incentives to broadcast their personal and private data. As Mark Zuckerberg, CEO of Facebook, is supposed to have said: “Privacy is no longer the norm,” implying rather that publicity is. Here take my personal data—please! Here—see what I am eating, who I am befriending, who I am dating, what I am wearing (or not), what I am reading, where I am checking in geographically, what I like, what I don’t like, what I am thinking—and at all times. [iii]
If you really need to have a private communication, send a letter by US Mail. It does put one in mind of Miranda Lambert’s country western song: “If you had something to say—you’d write it on a piece of paper—then you put a stamp on it—and they’d get it three days later—before everything became—automatic.” Words to live by.
This may sound a tad nostalgic; and I am not sure that I could explain it to an eleven year old. So, if your eleven year old is citing the 4th Amendment to you as reason for not handing over his password, congratulations! You have a Clarence Darrow for the defense in the making. I hope you can afford law school. But you then get to explain that “probable cause” creates an exception—and a parental search warrant. Hand the password over, buddy—or hand over the device!
Bullying: Recommendations for teachers and administrators
The media provide sensational, even tragic, reports about bullying, but they less frequently provide useful guidance or actionable information. We have to separate bullying from conflict and “drama” between peers of roughly equal power. Attention grabbing headlines have provided a “call to action” for educators in middle and high schools (and for state legislatures), who had been distracted by other priorities and looking the other way.
A few dramatic, high profile suicides, and many low profile emotional breakdowns, not to mention major litigation from outraged parents, have persuaded school administrators of the importance of intervening on behalf of the most vulnerable, bullied members of the community.
Yet it is also important to realize that grown ups are not the only source of relief from tween and adolescent bullying. In no way is it blaming the victim that the targets of bullying sometimes need to take crucial actions on their own behalf to improve the outcomes of unwanted assaults.
The first empathy lesson for administrators is that empathy is on a spectrum that extends from being firm about boundaries all the way to “tough love.” As every administrator knows, education is impossible if a school that is “out of control” surrounds the class room. A school is a system, and the hallways and class room must be calm in order for education to work. Before we turn to the details of how empathy plays in this context, some background is useful.
In December 1982 three elementary school students (10 to 14 years old) killed themselves near Tromsø, Norway. All three had been bullied. For example, one had been called a “leper” because of his measles scars, an insult, frankly, that I had not previously heard. These tragedies galvanized Norway.
Previously, bullying had been regarded as something that kids had to work out for themselves on the street. These tragedies provided evidence that the most vulnerable members of the community required intervention.
Dan Olweus, who had studied bullying extensively in nearby Sweden, but who was without popular support there for his research recommendations, was invited to come next door to Norway to help out. He surveyed 130,000 students. Some 15% were involved in bullying either as perpetrators or targets.[iv]
Olweus’ research challenged many assumptions. It challenged the assumptions that upper class high school students were less frequent bullies than their underclass peers or that urban kids were more likely to bully than their countryside fellows. Bullying was an equal opportunity issue. The targets of bullying were significantly weaker physically and more vulnerable to anxiety; but, for the most part, they did not look or dress significantly differently than others in the group. Space does not permit a comprehensive review of Olweus’ bullying prevention program; but its focus is on transforming the culture of the entire school, providing authoritative and positive role models, improved overall supervision, and intervention in individual cases. In the initial pilot, eight months after the program was introduced, there was 50% less bullying; but also significantly less vandalism and theft.
Olweus’ approach anticipated the crime fighting approach of reducing major crimes by fixing the broken windows in abandoned buildings and arresting the petty turn-style jumpers on public transit. These are individuals who might escalate to more serious offenses, if they are allowed to get away with mirror ones. They are halted early in the course of their boundary-violating careers. Their relatively minor criminal behaviors get cut short before they can advance to more serious misdeeds.
Norway devoted significant resources to the issue of bullying. Here in the USA legislative compliance mandates ordering schools to solve the problem of bullying without providing resources or money are taking the easy way out. And mandates to comply often do not work—precisely because a mandate without resources is at best a well-intentioned, but empty, gesture. To be sure, the indifference of some school administrators has been a cause for concern regardless of the (in)action of state legislatures. But the commitment of many, if not most, administrators is a cause for hope—and engagement.
Emily Bazelon reports on a case study—a school, Old Mill North, that had a reputation for roughness and was demonstrably spiraling downward. But it was pulled back from the brink and turned around by a program inspired by Olweus. This is not a one size fits all narrative, but numerous lessons exist that can be generalized.
No matter how inspiring or talented the individual teacher, education is impossible if a school that is out of control surrounds the class room. The hallways and class rooms must be calm in order for the process of education to get the traction it requires to produce educated students.
Bullies are put on notice that teachers and administrators are decidedly not happy about their behavior. Such individuals have been poorly socialized, and it is going to catch up with them. They need to get in touch with their inner jerk—have a conversation for possibility about recognizing one’s peers as peers—and learn how to respect boundaries. They can do better. If one can get the peer group to validate the language of respect for boundaries, courtesy, an optimum measure of toleration, and empathy, then their behavior eventually catches up with the rhetoric of respect and improves.
As noted, empathy is on a spectrum that extends from being firm about boundaries, but nice about it, all the way to “tough love.” Some students are not interested in respecting the boundaries that mark a commitment to education, and they really do not belong in school. Some 52 kids were expelled from Old Mill North. Likewise, the teachers were assessed. If they were not committed to transforming the culture of the school in the direction of excellence in education, they were encouraged to seek positions at other schools in the system. They were not expelled, but were counseled out. Some 22 out of 66 left the school.
How shall I put it delicately? This was no longer business as usual. At Old North, a significant minority of the student body was still more than a tad rough around the edges by the time they got to middle school. Some students literally did not know what to do when one student bumped into another student passing in the hallway. They needed to be taught to say, “Excuse me!” or “Pardon me,” instead of telling the other person, “Drop dead, loser!” Similarly, with common courtesy in the cafeteria. At Old North a broad intervention with the students provided explicit guidance in what was expected of them by way of behavior. Thus, the students were drilled in social skills such as acknowledging the feelings of others, making eye contact, and conflict management skills such as making a request, saying “no,” or agreeing to disagree. In short, they were trained in empathy.
Some bullies are indeed thugs, and need to be removed from the community to protect the community from them; but other bullies are themselves survivors of abusive situations (e.g., at home). They exhibit mental health issues, have a diagnosable cognitive impairment, and require intervention.
That is no excuse—there is never an excuse for bullying behavior. However, it does mean that to prevent repetition of the bullying after a suspension has been served, these individuals need guidance. Many need treatment. Whether such treatment is full-blown dynamic talk therapy or cognitive behavioral therapy, bullies may usefully undertake an inquiry into their own abusive behavior in order to shift out of a pattern that is creating misery around them. It is worth repeating: If it’s mean, intervene.
However, intervention is not the same as automatic discipline. Suspension and expulsion should be used only when the immediate concern is safety; and followed up with evaluation for the individual for depression, anxiety, conduct disorder, other emotional issues, or problems at home. Extrinsic motivation was also applied at Old North.
Using Positive Behavior-Based Interventions and Support (PBIS), along with the Pledge of Allegiance, the school day began with reciting the school commitment: “Be respectful, responsible, and on task.” That means: say “please” and “thank you”; do your homework; and participate in class.
An internal currency of courtesy was introduced. “Patriot passports” were blue slips that teachers handed out when students were identified as doing something well. The teacher meant it as a recognition and statement: “I liked the way you did that.”
A gimmick? Perhaps, but the underlying value was in building a positive relationship between student and teacher. Instead of handing out detention slips, getting into an adversarial role, teachers were in a friendly role of recognizing students for a job well done. Those teachers who used up all their blue slips got a gold star on their door—and more slips. The slips could be redeemed for PTA sponsored school supplies, ice cream at the social, a school movie, or getting to the head of the line in the cafeteria.
One word of caution. Peer mediation is not a good method for dealing with bullying. Peer mediation makes sense when the two kids are of roughly equal power. However, putting a bully and a target in the same room together is a bad idea. This is so even if a grown up is present to help mediate. Bullies are skilled at saying the right thing in the moment, and then retaliating later. If the students are roughly equal in power, and the infraction involved drama (not bullying), then peer mediation may perhaps make sense. But otherwise, it is just putting the fox to guard the chickens. Things are not going to go well.
Once a measure of calm was restored to the hallways at Old North, then those students who continued to be disrupters tended to stand out. They could be provided with the services they required to gain control over their behavior and emotions instead of missing even more academics by being sent to the principal’s office or suspended.
Instead of being given a suspension and sent home, the disrupters were given confidential psychological assessments for depression, anxiety, substance abuse, and self-esteem. They were required to watch videos about bullying, and consider their own behavior in relation to what they saw. Teachers who were chronic yellers were trained in other methods of de-escalating conflict with students who were disrespectful or difficult. This was not a two week effort.
Six years into the program, scores on standardized achievement tests had improved enough for the school to introduce the International Baccalaureate Program to further drive academic excellence. Reducing bullying is good for academics.
In summary, schools that support such efforts find that bullying of all kinds is reduced, not merely that directed at kids who are eccentric, socially awkward, new to the community, or LGBT. Of course, if the school’s grown ups are still struggling ineffectively with their own homophobic issues, then survivors must look for alternative communities outside of school. These alternatives outside of school run the gamut from sports to book clubs. It is not blaming the survivor to say, “Hey, it’s gonna take something from you, too, in building a community that works for everyone.” Martial arts and boxing are powerful compensatory activities for people who tend to be shy; but such people have to overcome their own introverted tendencies even to sign up. The very behavior that is stopping them is also part of the behavior that is leaving them vulnerable to bullying. The breakthrough is already present in stopping procrastinating and taking action to get such training.
In conclusion, the lesson is that empathy builds community; and communities demonstrate empathy by being inclusive. Yet rare is theindividual who transforms the authenticity and integrity of an entire community in order to join a community with integrity and authenticity. What would an anti-bullying club even look like? It might look like a LGBT alliance; but it might also look like a jogging, biking, or history club. Don’t just be “anti,” as proper as that is in the case of bullying; but be “pro” engagement, inclusion, and community.
As Daniel Burnham said in different context: “Make no small plans.” Empathy is the foundation of no small community.
[i] Christine Olden. (1953). On adult empathy with children, Psychoanalytic Study of the Child, 8: 111–126.
[ii] See “The Facebook Files: A Wall Street Journal Investigation,” https://www.wsj.com/articles/the-facebook-files-11631713039 [checked on Sept 27, 2021]; see also (now “ancient” history): Mike Isaac and Scott Shane. (2017). Facebook’s Russia-linked ads came in many disguises, The New York Times, Oct 2, 2017: https://www.nytimes.com/2017/10/02/technology/facebook-russia-ads-.html [checked on Oct 15, 2017].
[iii] Bernard E. Harcourt. (2015). Exposed: Desire and Disobedience in the Digital Age. Cambridge, MA: Harvard University Press: 90–93.
[iv] Olweus 1973/1993 in Bazelon 2012. Dan Olweus. (1973/1993). Bullying in School: What We Know and What We Can Do. London: Wiley/Blackwell; Emily Bazelon. (2012). Sticks and Stones: Defeating the Culture of Bullying and Rediscovering the Power of Character and Empathy. New York: Random House. This post and the corresponding chapter in Empathy Lessons rely significantly on Bazelon’s journalistic synthesis of the literature and her incisive interviews; see also James Garbarino and Ellen deLara. (2002). And Words Can Hurt Forever: How to Protect Adolescents from Bullying, Harassment, and Emotional Violence. New York: the Free Press (Simon and Shuster).
(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.
Bibliography, References, and Additional Reading
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(c) Lou Agosta, PhD and the Chicago Empathy Project
The Limits of Empathy in Politics
If freedom of expression and free speech are flourishing, but no one is listening, then empathy becomes a tree that falls in the forest when no one is present. Empathy does not make a sound – or a difference.
Even in politics empathy is always empathy. However, politics brings along a whole new set of questions, issues, and challenges by with which empathy is confronted and to which empathy gets applied. The political becomes personal, unsettlingly so at times.
What then is the limit of empathy in politics? This is the limit: the practice of empathy does not work well with bullies, sociopaths, psychopaths, QAnon style delusional thinkers, the criminally insane, and [some] autistic children.
The prevalence of bullying in the school playground and politics is widespread and toxic; and one should never underestimate the power of empathy. Never. Yet, if your political opponent is behaving like a bully, empathy is not going to be enough. You will need to find supplementary methods – empathy alone will not work on her or him. These hard cases literally will not “get it.” They will not perceive the empathy. They will not experience your empathy.
Worse yet, some bullies and psychopaths will accept your empathy and turn it against you, the better to control, manipulate, and dominate you. If the practice of empathy is not the way forward, how then does one deal with bullying without becoming a bully oneself?
The answer is direct: set limits. Set boundaries. Thus, far and no further! Stay in your own lane. Get back into your own corner. Stay in your own space. Keep your hands to yourself! In so far as empathy is all about firm yet flexible boundaries between the self and the other, a rigorous and critical empathy is engaged here; but until the boundary is reestablished, empathy cannot come into its own. Indeed once boundary violations occur and safety or security is at risk, the issue is no longer an empathic one – call for backup, implement self-defense measures, or escape and continue the struggle on another day.
The FBI hostage negotiating team understands that empathy reduces rage and upset; and they use empathy in context for that purpose, though, as far as I know, they do not use the word “empathy” as such. Yet once the bullets start flying, the time for empathy has passed. Send in the swat team. For an illuminating article on the margins of empathy see Elizabeth Bernstein on “Advice From a Hostage Negotiator” (WSJ.com 06/14/2020) [https://on.wsj.com/3ajoYon]. Law enforcement gets empathy. Bad guys watch out. Once again, never underestimate the power of empathy. Never.
In so far as empathy is all about respecting the boundaries between self and other, one group and another group, boundary setting is relevant to politics and empathy. So if one can reestablish a boundary, then empathy can be reintroduced, gradually, to guide us in how to cross back and forth across the boundary without submitting to bullying, provoking a temper tantrum, or getting stuck in breakdown.
Yet the shadow of the tribalism falls over empathy in politics. Empathy gets a bad rap because empathy is often limited in contemporary political debates to empathy of identity. However, empathy – and that is the innovation here – empathy is also empathy of differences. Key terms: empathy of identity and empathy of difference.
With an empathy of differences, in addition to identity politics, we get a politics of recognition.
Empathy shows up when one person encounters the other person and recognizes his or her differences. I hasten to add no one is asking anyone to give up or devalue his or her identity. The suggestion is that the Empathy of Differences lets identities flourish in a space of acceptance and toleration created by empathic recognition. The empathic recognition in turn creates a political arena where people can debate and compromise and get things done.
Talking a walk in the other person’s shoes yields an empathy of differences. One discovers the otherness of the other. The shoe rarely fits exactly right. One discovers where the shoe pinches – but the other’s shoe almost inevitably pinches at a different spot when it pinches one’s own foot, because the other foot is slightly longer or shorter than one’s own.
Though we are different, our interests, experiences, and aspirations as human beings are recognized.
Our interests and aspirations have areas of overlap – for example, we want our children to flourish; we want to be able to make a contribution to the community; we want to be secure in our private lives and preference. With goals pursued along different paths, our possibilities converge or diverge without conflict. Our opportunities align in parallel or intersect at right angles instead of clashing. We are able to cooperate and embrace workability instead of obstructing one another. We are able to build instead of tear down.
Once again, there is nothing wrong with the empathy of identity, but something is missing. What is missing is difference. The empathy of identity is ultimately that of proximity to family, tribe, and local community. As noted, there is nothing wrong with that. It is excellent. We would be less than human without it. But the empathy of identity is ultimately derivative and incomplete without an empathy of differences.
If one is limited to an empathy of identity, the result is tribalism. “I get you, man, and you get me, bro, because we are alike.” No one is proposing to try completely to abolish tribalism, but tribalism is definitely limiting and constraining.
All these different tribes sets in motion a trend, which arguably is tribalism’s own undoing, dissolving its identity – Republicans, Democrats, Progressive, Conservatives, Libertarians, Christians, Muslims, Jews, Hindus, Buddhists, Confucians, Quakers, all 198 member nations of the United Nations – not to mention the Chicago Cubs Baseball team. So many identities – so many tribes. If one gets and belongs to enough of them, identity starts to dissolve.
Tribalism itself sets in motion a dialectic whereby each individual can belong to multiple tribes with multiple identities and affiliations. If you participate in enough tribes and enough overlap between tribal identities, the notion of identity starts to dissolve into a kind of melting pot of multiculturalism, communalism, or ecumenical spirituality, 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 commonly shared values.
But absent such a dialectic of dissolution into a melting pot of identities– for example, in traditional societies or insular communities – the empathy within the communal group works well but breaks down at the boundary at which one encounter the other individual and group and their differences.
The innovative point here – to emphasize once again – is that empathy is about identity and similarity, but it is just as importantly about differences.
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 similarities. The other is different than I am. But without the other individual there is no empathy. Empathy is born in otherness. Empathy is born in the difference. Empathy is born in the difference of otherness and in the otherness of difference.
If that starts to spin, enjoy the ride. At least you are not alone – as the practice of empathy is the one thing you cannot do all by yourself. Empathy is a function of otherness. Without the other individual, there is only myself – oneself.
Solipsism is the philosophical position – the illusion – there the entire universe consists of oneself very alone – hence, solus ipse. One is 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 – and the resistance of the other emerges from differences – the otherness of the other. You need an other – and the other individual’s differences – to get empathy started.
Being open to the other person’s feelings, affects, experiences, beliefs, and resonating in tune with the other individual, yields inevitably both the similarity and differences of those feelings, affects, experiences, and beliefs. That is the empathic moment: I realize we are different and that difference lives and becomes accessible in the space of acceptance and toleration between us.
This brings us again to the limit of empathy in politics. Thus, the fundamental political question for a rigorous and critical empathy in politics is what to do politically with individuals and groups that one cannot stand.
What to do with individuals and groups who arouse a visceral dislike and antipathy that are acknowledged to be irrational? What to do with individuals and groups with whom one disagrees on policy, practices, perspectives, procedures, customs, or spiritual practices? The tribalism of the empathy of identity is not going to get you of this impasse.
The reduction to absurdity of the empathy of identity is humorist Tom Lehrer’s satirical song, “National Brotherhood Week”: “Shake the hand of someone you can’t stand.”
Humor and empathy are closely related. One crosses a boundary between self and other in both cases. In humor one crosses the boundary with aggressive or sexual innuendo; in empathy one crosses the boundary with gracious permission and generosity.
Lehrer predictably succeeds in being wickedly funny, though deeply cynical, as he sings an upbeat tune: “…The rich folks hate the poor folks and the poor folks hate the rich folks. All of my folks hate all of your folks – it’s American as apple pie! But during National Brotherhood Week – Sheriff Clarke and Lena Horne are dancing cheek-to-cheek.” Note that Clarke was a notoriously committed racist and segregationist during the early Civil Rights struggle of the 1960s and Lena Horne was a celebrated African-American singer of romantic smoky ballads – not a likely match up on anyone’s dating site.
While shaking the hand of one’s sworn opponent (or an elbow bump in a pandemic) is always a good start, it is ultimately incomplete. Unless an empathic context of toleration and acceptance is established for the hand shaking, the risk of shaking hands with someone you can’t stand is that one will end up despising the other even more.
Lehrer’s song ends by expressing the unexpressed elephant in the room “…[Be] nice to people who are inferior to you / It’s only for a week so have no fear / Be grateful that it doesn’t last all year.”
As the song implies, absent additional training in and work on empathy and critical thinking, the hypocrisy and prejudice live on. The practice of empathy becomes the practice of a rigorous and critical empathy.
The disciplined practice of a rigorous and critical empathy is on the path to well functioning political community and successful engagement with one’s political opponents and rivals. A rigorous practice of empathy requires critical thinking to guide it, and, in turn, critical thinking requires empathy to open the space of relatedness, acceptance, and toleration of differences.
This rigorous and critical empathy includes critical thinking. Critical thinking includes such skills as questioning in the sources of one’s facts and beliefs, examining and questioning one’s assumptions, assessing conflicting reports in the media, looking for hidden assumptions and biases, examining one’s own for conflicts of interest, recognizing one’s own mistakes and cleaning them up at once, basic listening skills, taking turns, and seeing if one’s conclusions are actually implied by one’s facts and reasoning from these facts. These are all important. But the number one skill of critical thinking is putting oneself in the place of one’s opponent, competitor, or colleague and considering the alternative point of view – cognitive empathy. Such empathy becomes a priority in a political context.
In conclusion, when empathy becomes a rigorous and critical empathy, then the limits of empathy in politics are the limits of politics, not the limits of empathy.
References
Tom Lehrer, National Brotherhood Week [performed]: https://www.youtube.com/watch?v=aIlJ8ZCs4jY
© Lou Agosta, PhD and the Chicago Empathy Project
A Rumor of Empathy is now a podcast (series)
Got to Empathy Lessons on Spotify: https://open.spotify.com/episode/1OvEwkDD9b3IH66erzehnM?si=MeQ6C1uTQDyYGuAUGbegBw ] [more episodes coming soon]
Go to all A Rumor of Empathy podcast(s) on Audible by clicking here: [https://www.audible.com/pd/A-Rumor-of-Empathy-Podcast/B08K58LM19]
A rumor of empathy (the podcast) hears of a report of an alleged example of empathy in the work, action, or conversation of a person or organization. I then reach out to the person and talk to them in detail about the work they are doing try to get the facts and confirm or disconfirm the validity of the rumor. Makes sense?
A Rumor of Empathy is committed to providing a gracious and generous listening, empathy, in conversation with its guests and listeners. Join the host in chasing
down and confirming or debunking an unsubstantiated report of empathy in the community and engaging in an on the air conversation in transforming human struggle and suffering into meaningful relationships, satisfying results and contribution to the community. When one is really listened to empathically and heard in one’s struggle and effort, then something shifts. Possibilities open up that were hidden in plain view. Action that makes a difference occurs so that empathy becomes less of a rumor and an expanded reality in your life and in the community. When all the philosophical arguments and psychological back-and-forth are over and done, in empathy, one is quite simply in the presence of another human being. Join Dr Lou for an empowering conversation in which empathy is made present.
Go to all A Rumor of Empathy podcast(s) on Audible by clicking here: [https://www.audible.com/pd/A-Rumor-of-Empathy-Podcast/B08K58LM19]
Lou Agosta, Ph.D., Listening With Empathy 