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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 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. 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
 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
Listen on Spotify: https://open.spotify.com/show/6nngUdemxAnCd2B2wfw6Q6
“CEO” no longer means “Chief Executive Officer,” but “Chief Empathy Officer.” This time one can hear the groans—from the executive suite, not the cubicles.
Empathy is one of those things that are hard to delegate. This role shows up like another job responsibility with which the CEO of the organization is tasked—along with everything else that she already has to do. As if she did not already have enough alligators snapping at various parts of her anatomy, one has to be nice about it, too? But of course empathy is not niceness, though it is not about being un-nice. It is about knowing what others are experiencing, because one has a vicarious experience and then processing that further to expand boundaries and exercise leadership.
This puts me in mind of a mini-case-history reported by Annie McKee in the Harvard Business Review (HBR).[i] In this case, an up and coming executive, Miguel (not his real name), goes from turning around many struggling divisions in a multi-divisional corporation to a kind of identity crisis about who he authentically is in relation to the possibility of empathy. Miguel is a wizard at finding profit and weeding out waste. Miguel goes from division to division (each big enough to be a separate company) working his financial wizardry. It seems to work.
If the case sounds like a thinly disguised version of the career of Jack Welch, who was CEO of the multi-divisional General Electric (GE) from 1981 to 2001, then so be it. Welch retired from GE with a package estimated at $417 million.[ii] According to some reports, Welch was nicknamed “Neutron Jack,” because, like the neutron bomb, he eliminated the people while leaving the buildings and the profits standing.
Welch innovated a management approach called “rank and yank,” now widely imitated. Each year, the bottom 10% of his managers, regardless of absolute performance, would be let go. Those in the top 20% were amply rewarded with bonuses and stock options, which were extended liberally from top executives to nearly one third of all GE employees.
Welch reportedly fought against, but did not solve, the chronic problem of Wall Street pressure to sacrifice the sustainability of long term growth for short term profit. Welch railed against the very system that he outfoxed brilliantly over a twenty year career as CEO, but, note well, only after he got his payout.
Regarding shareholder value, Welch said in a Financial Times interview on the global financial crisis of 2008–2009: “On the face of it, shareholder value is the dumbest idea in the world. Shareholder value is a result, not a strategy […] your main constituencies are your employees, your customers and your products.”[iii]
Now you are going to expect me to say this method was the epitome of lack of empathy, and from the perspective of the employees whose jobs were eliminated, it definitely lands that way. Yet that is precisely what Welch was hired to do. Thus, the context.
Next act, quick scene change back to Miguel. In McKee’s HBR mini-case-history, his corporate superiors inform Miguel that those employees who survived his restructurings now hate their jobs, teams are dysfunctional, and the “by the numbers” culture has become toxic. (I believe this did not happen at GE.) Miguel is told “fix it” or he will never become CEO (which is apparently part of his agreement and expectation).
Miguel hires Professor McKee as his empathy consultant, and he is making slow, all-too-slow, progress working with her in expanding his empathy when another set-back occurs. Miguel’s wife throws down the gauntlet, pointing out that he is never available for her and the kids even when he is supposedly physically present. This hits home, literally. This inspires Miguel to expand his practice of empathy to a new level. He commits to learning how to listen, relate to others as a contribution, walk in their shoes, and respond empathically.
Thanks to Miguel’s renewed commitment—and McKee’s consulting and coaching—the empathy training works. Miguel expands his empathy in time. All live happily (and empathically) ever after, both at home and on the job, in this “just so” story.
However, in the real world, the Miguel and Welch narratives dramatically diverge—as do fiction and nonfiction. As a celebrity CEO, the dynamics of Jack Welch’s personal vicissitudes were played out in the public press, so they are readily available to the interested gossip—I mean reader—and the details of Welch’s three divorces will not be rehearsed further here. This speaks volumes to most ordinary humans. Thus, the lives of the rich and famous.
The empathy lesson? There is an cost and impact to every initiative and project. The cost and impact extend to empathy. Empathy is expanded or contracted. There is a cost and impact to “rank and yank,” even for those doing the ranking (though, of course, especially for those who are “yanked”).
No one needs to feel sorry for anyone, reportedly the “yanked” walked away with nice packages, but this is not for the faint of heart. On a happier note, Welch goes on to found a management school, the Jack Welch Institute, in an initiative designed to rationalize and replicate the business methods and financial “magic” that he developed at GE. Some thirty-five CEOs heading corporations today have been trained in his method (mostly at GE, not his theme-branded school). The principles Welch developed are also delivered at business schools such as MIT’s Sloan School of Management. With the case of Welch in the background, one realizes that the mini-case-history of Miguel really does indeed conceal an alternative point of view. However, “alternative” does not mean “inaccurate,” but a re-description of events that points to a hidden empathic breakdown.
Miguel was doing exactly what his corporate superiors asked him to do. If the financial results were not sustainable after his departure, this was so much “regression to the mean.” Even the average profitability of the companies identified by the celebrated In Search of Excellence by Thomas Peters and Robert Waterman dropped sharply within a few years in the absence of sustained leadership. “Regression to the mean” means literally that when one performs above average now, get ready for one to perform below average later; when one performs below average now, get ready to perform above average later. The boss will predictably approve of the above-average performance and disapprove of the below-average one; but the subsequent performance is governed by “regression to the mean,” not the boss’ approval or disapproval.
For all the ambiguous comments made about Jack Welch such as “Neutron Jack,” he managed to create an entrepreneurial spirit in a giant, multi-divisional bureaucracy. Now that was both the good news and the bad news. For those employees looking to put in their time, performing routine tasks—and conforming—prior to collecting a pension, that was bad news. It demanded a way of relating to possibility that required innovation and transformation that was ultimately career ending for those individuals.
To his enduring credit, Welch inspired an approach to creating possibilities by his own example that he called “boundaryless.” In short, he broke down organizational silos by giving permission to cross boundaries between traditional functions in search of possibilities, i.e., innovations. The boundary crossing sounds like the skillful use of empathy in building and managing cross functional teams.
Welch formed cross-functional teams to brain storm and implement possibilities that had not previously been envisioned. He championed ideas and possibilities for improvement regardless of whether the ideas came from inside or outside the company. “This is the way things have always been done” became the wrong answer, or at least no longer the default reply. Note that “boundless” behavior should not be confused with boundary violations. Empathy is about crossing boundaries to give the other person the possibility of breakthrough contribution, doing so with respect and recognition, and in a way that preserves the integrity of the boundary.
Welch was in charge at GE for twenty years; he had sufficient time to train divisional leaders in sustaining his practices; and retain them in charge of the divisions he had restructured. During his tenure at GE, the company’s value reportedly rose some 4,000%.[iv] If that is not sustained value, I would not know it.
Meanwhile, Miguel’s bosses asked him to put relatively short term financial results ahead of team building, retaining the best people, entrepreneurial informality, and, like a good leader, he made it work—for a while. He made it work until the bosses decided they did not want him to do that anymore. Surprise! Then they told him, “Fix it or you’re gone!” Miguel’s listening—a key component of empathy—was operating at an advanced level. He listened well; and he gave his superiors back precisely what he got from them—and what they asked of him. It turns out his superiors didn’t like it as much as they thought they would.
It does put one in mind of the example of George M. Pullman, who is no longer the model for employer-employee relations. Pullman ordered the workers fired when they presented him with a petition in protest of a 25% reduction in wages.[v] Pullman as Miguel’s boss? Miguel’s superiors changed their minds, having gotten the benefits of the “rank and yank” approach. Boards are allowed to change their collective mind (and minds), and were now looking for a CEO more like Walt Disney, Marshall Fields, perhaps Warren Buffet or Sam Walton, after the latter had made their first billion dollars, and could afford to throttle back a notch, cultivating a kinder, gentler image.
My redescription of events? While it is accurate that Miguel was innovating with his own version of Neutron Jack, Miguel was also on the receiving end of the breakdown in empathy. He could not give what he did not get, and, by the time his corporate superiors figured out what they wanted, Miguel had perfected his version of the Roman invasion of Britain. The surviving Brits were reported to have said: “The Romans ‘make peace’ by creating a desert.” The Brits were not referring to an “empathy desert,” but the idea is similar. McKee’s case history is a nice narrative and a useful cautionary tale. However, the tale lacks credibility and confronts us with the next challenge, empathy: capitalist tool.
“The Lone Ranger” is a vanishing breed in today’s corporation. Modern work, from the upper echelons of the corporate hierarchy to the bottom levels of the lowest cubicle, requires empathy.
Whether sales person, software developer, accountant, or business leader, one has got to be “a team player,” “willing to go above and beyond the call of duty,” spend long hours on business travel, and be cheerful about it. One has got to get in touch with one’s empathy; and use one’s empathy to satisfy customers, teammates, stake-holders, and superiors.
In short, empathy is now a capitalist tool. Managers need to apply ample empathic skills. Managers are required to keep workers contented so that the workers can be productive. Managers are now coaches, facilitating employees feeling valued, so employees are emotionally invested in contributing to the team, team spirit, and the long hours and frequently uninspiring routine work required as a project hits “crunch time.”
Both managers and line employees must be able to turn empathy “on” for customers; “on” for team work; “on” for co-workers; but “off” for the competition; “off” for efficiency and discipline; and “off” for compliance and rule following. This ability to turn empathy “on” and “off” implies an approach that this book has questioned in arguing that empathy is a dial or tuner rather than an “on-off” switch. However, even if, for the sake of argument, we imagine empathy as an “on-off” switch, this calls for a level of skill in regulating empathy in which most people lack practical skill.
Consider. Customers pay their good, hard earned money for products and services, and it is a low bar to say that customers are entitled to be listened to, treated with dignity, and responded to empathically by a corporation and its representatives. The empathic engagement with and treatment of customers is demonstrably a rewarding investment.
How about employees? As a person moves into the work force, he is empathic because those in authority advocate for it as a form of team building. It is important that one be empathic in addressing the issues and concerns of co-workers, customers, and stake-holders.
Employees who feel that they are “gotten as a possibility” by their company are emotionally invested in the success of the company. They are inspired to go the extra mile to deliver value on their agreements, make extra effort for the team, and see their personal contribution in terms of the big picture. They are not just stone cutters banging away at a rock with a hammer; they are building a cathedral.
Neither the employee nor the manager “above” him have been trained in empathy, and it is not a part of their job description, at least in any explicit way. Though there are dozens of training firms in everything from compliance to conflict resolution, the number of individuals and firms in North American and the European Union delivering empathy training can be counted on the fingers of one hand. While that may be changing, expecting CEO’s to give empathy when they are not in touch with their own empathy, makes no sense. Nor is it fair either to the leader or would-be recipient. Welcome to the age of Machiavellian empathy!
Niccolò Machiavelli (1469–1527) was famous for saying that it would be best if the leader—the Prince, in his day—was loved, but it is essential that he be feared.
Machiavelli never actually said that the ruler, the Prince, must be perceived to be empathic, even as he ruthlessly wields power behind the scenes. But that is what he implied. In the context of politics, Machiavellian empathy refers to politicians who present themselves as being empathic while manipulating, spinning alternative facts, double dealing, and so on, behind the scenes. Machiavellian empathy shows up in business, too. If managers are not in touch with their empathic abilities, they are counseled to “fake it till you make it.” Many never “make it” and continue “faking it.”
Whether or not one authentically understands the experience of the other person is less relevant to the Machiavellian Empath than scoring points on a check list of concerned behavior.
Is this then the ultimate cynical moment? Is this the ultimate easy way out? Is this the reduction to absurdity of empathy? If empathy is about setting boundaries, where is the boundary? While not a complete response, one distinct limit to Machiavellian empathy is Lincoln’s famous saying, “You can’t fool all the people all the time.” Ask Travis Kapernick, Bernie Madoff, or Harvey Weinberg.[vi]
Strictly speaking, Machiavellian empathy takes nothing away from empathy’s intrinsic benefits and uses. Even if one wants to present the appearance of being empathic for propaganda (i.e., marketing) purposes, while continuing to operate with dubious business practices behind the scenes, reality has a way of catching up with appearances. Amazon said it was a wonderful place to work. Then the New York Times got some employees to comment on the record about “mean” behavior.[vii] Uber was disrupting the disrupters and creating the Gig Economy, which supposedly set us free. Then a driver, who was not in touch with that supposed freedom, unwittingly interviewed the CEO, Travis Kapernick, on camera.[viii]
So far as we can tell at this writing, neither of these breakdowns has resulted in breakthroughs. There is no guarantee that the Machiavellian Empath will slip up and document his or her own inauthenticity for us; it rarely happens rapidly enough; but it happens.
Empathy deserts grow: Woe to those that harbor empathy deserts!
Capitalism organizes empathy along with workers and production processes. Under capitalism, empathy is a means, not an end dedicated to the satisfaction of human needs, aspirations, and demands. (When the word “demand” is used, think “supply and demand” for products and services in a market.) Some workplaces are empathy deserts in spite of the appearance of mangers with published “open door” policies.[ix] Key term: empathy desert. After a day at the office, people often feel as if their personality had been erased. One’s humanity withers in the desert. So if you find yourself feeling dehumanized by your job, maybe you work in one of those, regardless of the prevailing rhetoric.
Instead of the industrial supervisor shouting orders to his workers, who curse under their breath and conform to the orders, today’s managers employ therapeutic strategies to create a convivial environment of trust, relatedness, sociality, loyalty, and care. Happy people sell. Happy people write more software code with fewer bugs. Happy people deliver projects on time, on budget. Value creation in the late capitalist economy is a function of the exchange of emotion and empathy.[x]
The way “empathy” is used in the business media today, it means that corporations innovate in providing benefits to their employees. Many of these benefits enable employees to get away from the job and restore aspects of their humanity that are hard to maintain in the “corporate jungle” (or desert). It means that firms return to their employees some of the revenues that the employees earn for the firm by providing services. Such a proliferation of meanings may be a phase that empathy has to go through before we can really grasp how it essentially makes a difference.
For example, Procter & Gamble offers a personal leave of absence, which the employee can use to engage in a “life project.” Up to three months off without pay—but with continued benefits—allows the employee to pursue a personal “life project,” and, P&G to retain valuable talent, since the employee returns to work after the sabbatical.[xi] Though Human Resources (HR) has to approve the project, the benefit can be used to: complete writing a PhD or masters thesis that requires dedicated time on task for writing and research; design and implement a database tracking system for a social justice issue for Amnesty International or Doctors Without Borders; trek to Nepal and attempt to climb an 8K meter high mountain; sail around the world.
At Google (Alphabet) parental leave is a benefit: Moms get up to 18 weeks of paid leave; Dads get six. The company also pays “baby bonding bucks” to help with initial expenses such as formula and diapers.
Prudential Financial is addressing the employee challenge of being a care-giver for a parent or relative by providing adult care in an employee or loved one’s home. The company provides referrals to geriatric care services as well as elder law and adult care-giving seminars.
IBM contracts with an educational firm to provide a “get into college coach” for its employees with children applying to college. They will not write the admissions essay for the children, but provide detailed guidance as to what different colleges are looking for, test scores, grade point average, and cultural preferences. All these are valuable in reducing parental (i.e., employee) stress. Note this is one corporate benefit that does not require the employee to leave work. Sensibly enough, the worker continues to work, presumably to pay college tuition, while “out sourcing” some of the elaborate, complex project planning needed by the student actually to get into college. Win-win all around.
While my work has repeatedly emphasized that there is enough empathy to go around, empathy is not uniformly distributed. How could it be? Executives who are talented at dealing empathically with customer issues may be less skilled at dealing empathically with employees; and those skilled at dealing empathically with employee issues may be less skilled at dealing empathically with union negotiations, the press, or business partners and competitors (who may be one and the same).
Arguably, empathy flows from those with more power towards those on the front line engaging with customers. However, if the customer is big enough, for example, contemplating buying a fleet of jets or a global enterprise software system, the ultimate sales person turns out precisely to be the CEO or her close colleagues. The executive suite is now on the front line. But who trained those leaders—or any one—in empathy? If we gave the executive (or front line help desk person) the kind of empathy exam described above by Leslie Jameson, in which an actor learns a script, portrays a client with a problem, in effect being a “secret shopper,” what would be the grade (see p. 121 above)? While we may never know for sure, I predict that the grade will be lower than if the executive fills out a self-assessment in which one can pick out the “right answer” based on common sense and an appreciation of kindness. Thus, the case for expanding empathy through training.
[i] McKee, Annie. (2016). If you can’t empathize with your employees, you’d better learn to, Harvard Business Review, November 16, 2016.
[iii] Ibid, Jack Welch, Wikipedia
[iv] Ibid, Jack Welch, Wikipedia
[vi] Meanwhile, more breaking news, as this book goes to press, some 49 men stand accused of sexual misconduct in various workplaces extending from Harvey Weinstein’s Hollywood production company (from which he was fired) through venture capital to restaurant businesses:
https://www.nytimes.com/interactive/2017/11/10/us/men-accused-sexualmisconductweinstein.html?_r=0. The problem is that, while it is good that this abuse is finally coming out, it has been hidden in plain for years and years. See Harry Markopolis’ (2010) statement in a different context above, “no one would listen.” Where is Lord Acton when we need him? Lord Acton said: “Power corrupts; and absolute power corrupts absolutely.”
[vii] Kantor and Streitfeld 2015..
[viii] Seyluk 2017.
[ix] Roman Krznaric (2104) quoted in Belinda Parmar (2014) The Empathy Era: Woman, Business and the New Pathway to Profit, London: Lady Geek: 91. Parmar does not cite a page in Krznaric.
[x] Tristam Vivian Adams. (2016). The Psychopath Factory: How Capitalism Organises Empathy. London: Repeater Books: 56–77.
[xi] Matt Krumie. (2016). Ten companies putting empathy into action, Cornerstone On Demand: https://www.cornerstoneondemand.com/rework/10-companies-putting-empathy-action [checked on July 03, 2017].
(c) Lou Agosta, PhD and the Chicago Empathy Project
Here is the verbatim transcript of the complete conversation between Lou and Arnon Rolnick, PhD, about Sherry Turkle’s work on Reclaiming Conversation (also the title of one of her books), and including her memoire The Empathy Diaries (2021) and the debate about online therapy.
For the complete video see: https://youtu.be/6OId-0QDFys
To listen to the podcast on Spotify: https://open.spotify.com/episode/6K8byq8UAs85lnVcSAj4DJ
Lou Agosta (Chicago, USA): Today’s conversation is entitled Reclaiming Empathy in Video Conversation: An Imaginary dialogue with Sherry Turkle. Today I’m having a conversation with my colleague and friends Arnon Rolnick, PhD, Psychology. I will let him introduce himself momentarily. Just once thought upfront – his commitment is to integrating biofeedback, psychology, and technology. He says – and I believe it is accurate and true – that he is incapable of being indifference. His exuberance, enthusiasm commitment and empathy are an inspiration to me, and I believe will be one to the listening, viewing audience. Great to see you!
Arnon Rolnick (Tel Aviv, Israel): Great to see you and thank you for such a nice introduction so I want to share with you my almost 30 years of effort to integrate Psychotherapy Psychology and Technology. As a clinical psychologist I’ve been baffled by the power of those who characterize life in the 21 century. On one hand, technology and science are providing us with better ways to live; yet, on the other hand, people are suffering more. It is as thought technology helps us to neglect our selves. And before I will say a few words about my work in this area, I want to say why she [Sherry Turkle] is so important. She was a Pioneer and a guru.
Lou: A pioneer and a guru
Arnon: Yes – I will say a few words about my work and then the issue of empathy will lead us all the way. So it was her book The Second Self where she defines this computer as more than just the tube but part of our everyday personal and psychological lives. She looks at how the computer reflects on ourselves and our relationships with other. She’s claiming the technology defines the way we think and act. Turkle’s book, which was really the first one in this area, allowed us to view and re-evaluate our own relationship with technology. This was her first book and this was that the first moment that I thought “Wow!” interesting. And then came my own work as a psychologist. I felt that there is some gap between what happened in the meeting [between therapist and client] and then the person is going home and he either forgets or doesn’t do I what we decided he was do so. I thought we would like to do what in CBT they called homework I don’t like the name “home work,” but most people know
Lou: Cognitive Behavioral Therapy [CBT} and assignments there are sometimes assignments. Back to you
Arnon: II will even appreciate it, Lou, if sometimes my English is not so clear, you will help the audience to understand my accent. So it was sometimes early in 1995 – see how old am I – I think I work with biofeedback I thought why don’t you give that the patient not only a biofeedback but also a CD that you can work at home and we call it “De – Stress” and we sold it in Boots – you know the British Pharmacy [Boots the Chemist] and I so I thought that should be there the killer [“killer app”] that should be the most important thing you give to the world and apparently it didn’t work
Lou: You send the patient home with a CD and there is an interactive media here – so already we’re in the online digital world and the patience or the clients or the individuals struggling – so what happens? They still are not that engaged? Explain it – what is the take away here?
Arnon: I will explain it – a little bit later when I speak about “Beating the Blues” – then the company – the British company hired me to help them develop already for the internet – first for the first CD – the program of cognitive behavioral therapy to help the patient overcome depression and anxiety. I thought again it would be wonderful idea – after seeing the patient, he will use this CD. The company thought differently. She said we don’t need a therapist. Just we will give them this program: eight 45-minute sessions and they will be cured.
Lou: And so you become [in]dispensable – you think maybe this is not going to work exactly as the British UK publishing company is imagining. But at some point, if the once the therapist, the psychotherapist, has designed the assignments, we no longer need you. So keep in touch! Have a great life good! What happened?
Arnon: What happened is very interesting. There were about eight good [unintelligible] that it works. I felt strange – it was a good program – I was part of it but could it really replace the human element? Later on it was found that the picture is more complicated. It works well only when there was a nurse involved her and she helped them to do the program so the nurse…
Lou: Let me just to interrupt you here. it sounds like the human element – so you’re already dealing with the human element and the technological elements whether it’s a CD or whether you know it goes fully online in the cloud as we have it today and it turns out what turns out we have the psychotherapist step aside and it [the nurse] turns out perhaps to be the replacement therapist.
But we’re just calling him or her a nurse shows up – and we suspect the human touch – the therapeutic Alliance if you will – the Rapport between human beings may be a hidden common factor
Arnon: Exactly. But this will allow me later after you will introduce your work and that will help me to divide the Psychotherapy into two main camps: the technique camps and the relationship camps. And I will talk about it only after you will tell us about your work about empathy
Lou: That sounds like a good segue for me to say something about empathy and we’re going to do it – so hold that thought: there’s the relationship camp and the tips and technique camp. And so hold that though – and so back to me – thank you! I appreciate the shout out – who the heck am I anyway? One claim to fame that may be more than one but is to have authored three peer-reviewed books on empathy, starting with A Rumor of Empathy – in effect, virtual volumes one and two and then Empathy Lessons and Empathy in the Context of Philosophy. My PhD from the University of Chicago began with a dissertation on Empathy and Interpretation – so I’m not going to give the storied, complicated history of the distinction empathy at the time I was a graduate student. It’s a matter of public record, my dissertation adviser, Stephen Toulmin, was being psychoanalyzed by the colleagues here in Chicago I don’t know the name of his analyst – he may have told me – but Kohut was innovating in the matter of empathy and his colleagues Michael Franz Basch, Arnold Goldberg, Ernie Ernest S Wolf were innovating in the matter of Self Psychology – and is there anything to this concept empathy or is it just cumbaya stuff? Really what’s the intellectual Providence? And it made a great dissertation for young graduate student and it is something meaningful to engage and so fast forward – I am not going to tell you about all of these books – they’re there’s actually available from your local online book seller. What I propose to do is provide really – no kidding – the one minute empathy training. You can actually do it in a minute. Now there are some conditions and qualifications – and so here it is: Drive out – get rid of – reduce – drive out things such as aggression, hostility, bullying, cynicism, resignation, bad language, politics in the pejorative negative sense – you know we are political and often times it doesn’t bring out the best [in us] – drove those things out – and empathy naturally comes forth – people are naturally empathic – people want to be empathic – and will be so if given half a chance. So that’s it! That’s the training: get rid of the negatives and empathy shows up in the space of relatedness. I pause for breath. I see you have a question.
Arnon: Being also trained in psychoanalysis you’ll clearly represent the Kohutian self psychology view – people are good – but what about the Kleinians? How can we get rid of our aggression
Lou: Well, thank you! I mean thank you: I mean human beings are naturally empathic; human beings are also naturally aggressive. We are a complicated species; and I have no easy answer. The difficult answer is that often times hostility and aggression are reactive. If you want to see somebody get angry – if you yourself get angry – if I find myself angry or even enraged, [then] one good question to ask myself – yourself – the people in the listening or viewing audience: who hurt your feelings? who perpetrated a dignity violation? or where did you not get the empathy and respect you deserved? cuz if you want to get a person angry, hurt their feelings – say something devaluing about their parents. It’s not going to go well. If you say something bad, it could get messy it’s just I have no [easy answer] – I mean we acknowledge the contribution of Melanie Klein. [Klein was] an incredible innovator. Let’s talk to some children. Freud’s innovating – Anna’s innovating – he’s got some ideas about infantile sexuality. Melanie Klein comes along – herself kind of a tortured genius in her own way – [she says] let’s talk to some children – and play therapy is invented. What a breakthrough – so I don’t know – there’s a lot of room for disagreement here but I’ve also seek some over lap and common ground. Hostility and aggression: there are a lot of things that can cause it. I mean, some of it may indeed be in it and species-specific. Nevertheless, who gets their feelings hurt and who experiences an empathy break down [or] a dignity violation. I claim that’s a candidate answer and so I may continue or you can get follow up
Arnon: So I think I’m responsible for the digression.
Lou: A digression but a productive one – so we finished the one minute empathy training; and there’s a lot more to be said about empathy – here right now. [However] We’ll come back to that. I’m going to segue – I think usefully – I’m going to begin a conversation about the contribution of I believe it would be: Madame Professor Dr Sherry Turkle, PhD, social psychology MIT (Massachusetts Institute of Technology). On a personal – the occasion is – I’m going to wave the book – [Lou holds up Turkle’s book, The Empathy Diaries, on the on-camera version of this conversation for YouTube] here her Memoir is published The Empathy Diaries (2021); and there she is as a child of tender age in the 1950s and the 1960s, coming up on the residential part of Long Island. The parents [actually] grandparents are Holocaust Survivors. They escaped Eastern Europe; and her mom marries a man named Mr. Zimmerman. Something is immediately strange – an unconventional something comes out. He’s performing certain kinds of I should say weird experiments that end up sounding like the work done by Mary Main and John Bowlby on attachment [the blank face gesture]. He’s leaving the kid – the young Sherry, the kid – forgive me, Professor Turkle, of tender age – alone in her room, .and letting her cry your eyes out. This guy has gotta go. The mom divorces Zimmerman and marries Milton Turkle, who has issues of his own, but two other children come along, her younger siblings. And here’s the – here’s the empathic moment – here’s the moment of the break down of empathy. At home she’s “Sherry Turkle’; [but] at school, somehow given this bureaucracy, she’s a Sherry Zimmerman. Now in our time, this is second about to be now third quarter 2021, blended families what’s the issue? It’s somehow devaluing, stigmatizing, divorce- you know, the feminist Revolution is occurring but divorce is still an issue one in this community – it is a Jewish community – non observant – living in genteel poverty – coming up in a kind of genteel poverty. Here’s the problem: [pretending to be Sherry’s parents]: “Sherry, you’re not allowed to talk about it. You’re not allowed to talk about the fact that your last name really is Turkle but at school, it’s Zimmerman.” Holy mackerel! It’s a two-tone elephant in the room. It’s [confronting] and so here is my short review: this is a great memoire. It is in many ways a page-turner. I was engaged, and I’ll say just a little bit more about that [soon], and it is also entitled The Empathy Diaries, [but] it might be also [be] entitled The Breakdown of Empathy [diaries], because it gives an account of what Sherry has to survive to reclaim for Humanity. It goes well – she’s smart – her parents tell her or grandparents tell her: “Look, you are not going to typing class.” This is amazing – this is the 1950s. If she learns how to type, she will end up in the secretarial pool. “No, Sherry, you are going to be in the front of the class. You are going to be the teacher” They don’t let they refuse to let her do housework. “Read!” they say. I heard something similar in a kind of weird way. This is a way of improving one’s life and one’s humanity and of getting some empathy. She goes to MIT. She meets – she goes back and forth for a while. She ends up at the University of Chicago about a couple of years before I was there. So it is a page turner for me, cuz they’re she is in Social Science 122 – sitting in the classroom – Social Sci 122 – and in comes Professor Bruno Bettelheim. He brings his straight back wooden chair; puts it on the low stage; and the students, who are trying to speak truth to power, give it to him, he gives it to them back – [Bettelheim is] the author of so many books: Love is Not Enough, the empathy fortress, [oops, I mean], The Empty Fortress, The Children of the Dream – over to you for a digression – insert your story here – he goes and visits a Kibbutz for a few months and says a few things which become controversial – you grew up there – tell me –
Arnon: I was born in Kibbutz and I was there raised there in this unique type of experiment – experiment – experiment – and you know what? We still don’t know that result of the experiment. What I mean is that we develop in so many ways and how many of us became leaders in various areas but we also have some pain and maybe it has been in his own way. May I take the leave now?
Lou: You have the conk shell –
Arnon: I want to say that again Sherry began with computers and she was fascinated with computers in particular and slowly she changed her ideas about the problems with computers – for example, she has many books – but I speak about two of them – both have explored how technology is changing the way we communicate – in particular, she raised concerns about the way in which organic social interaction can be degraded through constant exposure to lose every meaningful exchange with artificial intelligence. I will speak about artificial intelligence later on. In [Sherry’s book] Reclaiming Conversation, which is the book just before the one you mentioned
Lou: Reclaiming Conversation [Lou hold sup the cover on camera]
Arnon: She is arguing – she is gathering data from schools [and] companies [and] families – she says: we forgot [how] to speak with each other. We [are] all the time doing it via devices – we type – we send SMS – but we don’t talk and that’s led her to the interview that we will talk [about] later on where she kind of arguing – and maybe you will express it better – that online therapy is something completely different from psychoanalysis – and we will talk about this [more later] – but let me come back to this distinction between the two camps – and I will try to explain how the internet when it entered into the Psychotherapy world how it affected the two camps in different ways. So let’s begin – what are the two camps? The technique camp and the relationship. And everybody who knows Psychotherapy – you know that there is the group that thinks that their relationship is (a) very important aide in understanding the problems of the patient and (b) in maybe curing. Now you know that the earlier relationship with the parental figure is very important and this might be reflected later on in the relationship with therapist so that that camp is clearly or might be worried or interested about how does online therapy work. It seems like you want to comment and talk or should I continue?
Lou: – Well I have some comments I mean I think you hit the nail on the head so to speak in that the book you refer to – Reclaiming Conversation – she launches a Jeremiad – she is on a tear – you know, remember the Prophet Jeremiah in the Hebrew Bible? He was angry about something – we’re talking about anger – and it’s not clear whose feelings got hurt – but the feelings of the people at the dinner table where dinner conversation and conversations between friends are interrupted by beeping, buzzing, alerting smartphones – she is on a rant that we have got what amounts to acquire attention deficit – it’s not like we were born ADD or ADHD – amphetamine-based interventions will not help, because it is acquired through the number of interruptions that – so she’s, you know, [on a tear] and that’s the immediate trigger if you will, which, I believe, you’re expressing – what I would say is you are then tracing the conversation in the direction of online therapy – and it’s because – I mean – it’s now, you know, we’re emerging from this pandemic – the positivity right here in Chicago – hopefully – fingers crossed – we are jinxed now, I said, but – let us not do magical thinking. The positivity rate in Chicago is last week was .6 per cent and I had said the pandemic is at least temporarily over when it hits .5% but on other places it’s 6% and 10% and the struggle continues and we are really not going to go into it and there is a conversation about technology which we are not going to go into – technology can be used for great good and there can be big issues with it. That’s the point I wanted to make. She launches a Jeremiad – back over to you.
Arnon: We spoke about the relationship camp and how they acted to [towards] the Internet and I mentioned the technique camp – this camp who believes that what changes people’s behavior and thought and emotion is: we should give them technique. It could be cognitive behavioral technique – it could be emotion-focused therapy – it could be hypnotic technique.
Lou: You are not anxious or depressed – you just lack skill – that’s an enormous over-simplification, but there may be some useful techniques that can be improved and manage one’s anxiety and depression in a downward Direction
Arnon: Yes, and I should have made [note] that part of my research has dealt with this CBT techniques and I’m not I’m not in any way against it [unintelligible] Now what happened when the Internet entered the picture? Beating the Blues
Lou: Beating the Blues – I’ve got the name of the British company – we give them a shout out if they still exist: Beating the Blues – sounds good.
Arnon: But there is today ten thousand applications programs trying to do what beating the blues did, and it’s amazing how people are still trying to help or be helped by online application. Now just a the beginning of June there is a big article in the New York Times about an application called something –BOT – Webot – something – and it says that this application is working so well that one cannot differentiate if the bot – this machine – is a human being or behind it [a computer] or in fact, they are using a some engines like Google is doing now and – has developed Meena – a computer or machine –
Lou: A system of hardware-software stuff – Meena –
Arnon: That passed the tutor test –
Lou: The Turing test – Allen Turing – can I tell the difference between – in a conversational exchange between someone who supposedly hidden in a room or a machine or a device the Turing test and it turns out – we think – natural language has fallen to a technology that we now have technologies that can simulate natural a conversation with another human being the debate continues
Arnon: The debate continues and it is interesting to note that Sherry Turkle was married to one of [the members of] the group that developed Eliza. Eliza is another very early program that used Rogerian concepts to try to imitate Psychotherapy. Of course it was by far more simple. But let’s go back to the technique camps and a lot of effort to get rid of the psychologist I do at what Sherry Turkle says “the robotic moment.” She has a very strong anxiety – or she’s afraid that this artificial intelligence idea making – how can I say? – It’s dangerous to our humankind
Lou: Humanity – yes – yes –
Arnon: Humanity – I spoke about the technique camp and they’re mistaken direction; and I agree with Sherry [as] she speaks a lot about the dangers in this robotics [approach]. Oops, my chair almost fell.
Lou: If you disappear off camera, we will await your return. Maybe I can pick up the thread usefully at this point and a segue to the immediate occasion where you called me a few weeks ago and you said: “Hey, you know, let us have a conversation about her concerns and objections. I mean, she’s got some energy for this matter. She publishes – and I’m going to quote the publication that catalyzed our back-and-forth conversation: Afterward – here’s the title: “Afterword: Reclaiming Psychoanalysis: Sherry Turkle in Conversation With the Editors of Psychoanalytic Perspectives,” Volume 14: 2017 in this one and in this article, she raises a number of serious objections about the very possibility performing online therapy and she makes the case for co-presence. What I want to say at this point is –
[Video freezes and Internet connection is lost – connection is restored]
Arnon: We had some problems – we don’t know where was it – I don’t hear – you are on mute – we can we use this moment – I don’t know what exactly happened
Lou: I’m so I’m just going to pick it up I’m going to pick it up at “Afterword Reclaiming Psychoanalysis: Sherry Turkle in Conversation With the Editors of Psychoanalytic Perspectives
[[Video is frozen again – and connection lost]]
Lou: You were frozen
Arnon: You were frozen also
Lou: Things like this happen
Arnon: And it happens in online conversations – just a moment – and the question – how the therapist and the patient react to this? One could be completely angry – the patient – or the therapist could be: I’m not psychotherapy online anymore or we could use it
Lou: I mean you might reboot the router too for that matter – that could make a difference – 3, 2, 1 – the name of the article in Psychoanalytic Perspectives, Volume 14, year 2017: “Afterword: Reclaiming psychoanalysis: Sherry Turkle in Conversation With the Editors of Psychoanalytic Perspectives” – and in this – I must say – this was 2017 – I listened before the pandemic – then she denounces – I would say it’s not too strong a word to say she speaks in a devaluing way about online therapy, and [she] considers that psychoanalysis is missing the opportunity to emphasize the presence [of] the being together in the physical space – and all of the issues that occur there, which I will shortly enumerate – and what I really want to emphasize here is that there are at least three objections that she has: she says, lookit, online, to make eye contact with another person, you have to look at the green dot [the “camera on” LED]. I’m looking at the green dot. And it looks like I’m looking directly at you but when I look at Arnon’s eyes, I’m actually looking away from the green dot. So it’s not like sometimes, if you take a step back, it’s not clear where you are looking, but in person there’s a kind of code presence which is makes also, I think, an interesting but perhaps questionable point – so I want to be an honest broker here and charitable – who makes the point what starts out as being better than nothing – key term: “better than nothing” – in it pandemic, you can’t meet in person. So it is so, as she acknowledges in a podcast in July 2020, at the height of the pandemic here in the States, you can’t go to visit in person. It doesn’t work – you can’t – it’s impossible – it’s forbidden – and when we get back at someday out of the pandemic, from which we are (arguably) emerging at this time, the problem is (she sees) is that there will be friction and resistance to meeting in person where our fullest Humanity, if you will, empathy in the sense of being present with another human being in the same physical space embodied in a physical way. And so being “better than nothing” becomes “better than everything,” “the best of all” in so many words. And, finally, well those are her two points, and she says psychoanalysis may be missing a great opportunity here to take a stand and then she talks about a number of issues including [incomplete thought] – but she doesn’t say, you know, how to use the couch online – the couch – lie back on the couch – free associate – I’ve seen people who lie back on the couch and immediately have a breakthrough. They think of things which they were aware of – that they have not really been unaware of them – but we’re just kind of shoved back in there you know in their consciousness -in their inner sanctum, and all the sudden lie back and relax a little, and, oh, my God, I remember this or that about parents, about friends, about current relationships that they had not been aware of; so it can be a powerful tool and how does that work online? It doesn’t come up in this particular article. I pause for breath.
Arnon: The issue – is that the real psychoanalysis – is that typical discussion in psychoanalysis for many years – and now when Sherry Turkle says this is not psychoanalysis, speaking of online therapy – she is repeating and doing what many people did years ago before when the question was being on the couch or not being on the couch or sitting front face-to-face was considered not psychoanalysis
L: Somehow it was not echt – not genuine or authentic enough
Arnon: Yes, it was not the real classical Freudian in the day – and also the question should it be five times a week or three times a week – so psychoanalysis all the years is it the real thing or not the real thing and in this way I look on Sherry Turkle context can be partly understood – old psychoanalysis – is it true or false – in the 1950s when people said can you do psychoanalysis via the phone there were articles that said, you can do it but it is only supportive therapy – so what I am trying to say is the relationship camp was very much obsessed with the question was it the right thing as regular therapy or not regular therapy – so what I am saying is it is clearly different but it might be interestingly different – we might even find some advantage and learn a little bit what works in psychotherapy – for example, now when we are talking to one another, is it the content, my interpretation or is it my fault my visual appearance, which might be even bigger than what we you would seeing if you are in the end and I turn. You can see my face – my bird [beard] – my eyes – and like that so, and look. For example, I can do now this [Arnon zooms in and out with the camera] I’m going backward and then zooming
Lou: Amazing – we are gong to zoom in – we are literally zooming – and so may I jumping in at this point, because you raised a number of questions – now this is now not Professor Turkle (Sherry) – this is Lou Agosta: We may usefully have a phenomenology of presence – of online presence – just as we have the philosopher Merleu-Ponty talking about embodiment and a number of researchers [on the subject]. There is need for that, because the image is different than the physical presence – sometimes – it’s – it’s just different – it’s not better – it’s not worse – it may be richer in some sense and then less dimensional in another sense – and so, you know. I mean I could see – she doesn’t call for this, but she might usefully do so. The second idea: take a transcript of an in-person psychotherapy session and take a transcript of an online session. What’s the delta [between the online and the in-person]? How could you tell? Now the Internet blows up as it did a moment ago in our conversation, then you know we’re online. If the patient comes in and says, well the traffic was horrible, then you know you’re on the ground. But remove those deltas – remove those considerations – I suggest that in most cases – but interesting ones may not be on the list of most cases – one could not tell the difference, because therapy is basically a conversation – it lives in language – but [unintelligible] what about those instances [that are] new forms of Freudian slips. An anecdote: I met a new patient I had a second meeting with the individual – we use some version of Zoom – she gets up – the device is moving around the apartment – she goes to the kitchen – goes to the oven and says “pardon me, I got something in the oven” I am thinking – this is now would not be in the transcript – my thought would not be in the transcript – I’m thinking: Okay, this is amazing – this is practically like an enactment – an acting out – a Freudian slip – and I [think to myself] sometimes clients wonder whether their therapists know what they’re doing – it’s a valid question to be a little bit skeptical when we are consumers of psychotherapy services – does his or her therapist guy knows what he’s doing; and I said I’m thinking it’s a new relationship, but people are a little ambivalent about how they feel about their therapist and I say to her: “Do you perhaps think I am half baked?” She’s got something in the oven – she is baking a cake – it’s denied yet the thought is there – you can’t make this up – you can’t make stuff like this up – so that would be a delta – you get new forms of slips of the tongue, parapraxis, Fehlleistungs. Make no mistake, the transference is always the transfer, and so, this does not come up in Professor Turkle’s work. It might usefully do so, because the genie is out of the bottle.
Arnon: I think the example you gave is wonderful. Being a more CBT like therapist, I would not interpret as Half Baked or those things like but I would say: Wow. What a wonderful opportunity to see you are working – have hobbies – that you can cook – you see, what I am saying is the fact that the therapy is not now in our clinic but in in her room – her place, helps me know things about her self that I would not know – so instead of fighting this – and lets make the room exactly the same – let’s use this uniqueness that I can see their room and maybe they can see my room which is again interesting.
Lou: It is significant, and I would tend to agree, and I claim that I was using it to explore the relationship and it’s true my countertransference was like can – one version of empathy is to be fully present with the other person – and I think Turkle – I mean, she doesn’t actually define it that way, but I think Sherry gets that – she appreciates this matter of copresence and really being with the other. I mean just like, you know, if this dialogue between you and me, Arnon, we go back a bunch of years – you know, if it were successful beyond all of our dreams, notwithstanding internet interruptions, we would succeed in making present a certain empathy. I mean, like I got you, man, I know, you know, we’ve been struggling with these issues for a lot of years, and now that’s a criteria of success: that we bring it forth – and we [are] doing it online. Hey! Hello! We are having [an online conversation] – we couldn’t do this on the ground. I mean you’re in Tel Aviv – we didn’t put this at the start of the video but you’re in Tel Aviv – I’m in Chicago Illinois – it would not be humanly possible otherwise
Arnon: Right – right and that brings me again to my belief that we are reclaiming conversation – we are reclaiming conversation of [as] Internet dialogue and that it works very well – and let me tell you I am doing it for almost twenty years – and I prefer still to have the patient in my clinic – but I clearly suggest to our readers or audience not to go in either direction – not to say that technology will replace the human element and, on the other hand, let’s use technology. May I just add one more thing that we are currently struggling with – remember I want the therapy to continue only by the one-hour session. So the question comes, can we use technology not only by doing the one-hour session but by [for example] I am doing quite a lot of couples therapy – can the couple call me in the middle of a crisis – they are at home –
Lou: That would be powerful – that could be power at the moment, the enemy (so to speak} – the issue is present at the moment
Arnon: That would be one way to enlarge therapy – the second thing I am doing – according to the technique camps, not the relationship – I am using application, but the application is not trying to replace me but trying to resonate our interaction. Suppose you are now my therapist and I was your patient and you will use this resonator application to resonate [saying to me] remembering how we felt when we had this problem – the idea: so we can use technology in many other ways not to fight it and not to say this is everything.
Lou: Technology – surely, I mean this is a cliché, but perhaps hidden in plain view – technology can be a two-edged sword. Like any communication [device], it both connects and divines – I mean, we are relatively inexperienced with online therapy. I said earlier, dropping in the [conversation that the] genie is out of the bottle. In her in her podcast in July 2020 at the height of the pandemic, Sherry expressed concern that there would be a lot of friction, as she said, to going back to in person meeting just as there apparently is a lot of the people going back to the office and to their cubicles in person, and in some cases it’s essential and in some cases it’s definitely not required, and so how to tell the difference becomes the challenge. And it does seem like there is something – she makes the case, I mean, with which I must occasionally and in many ways align, that she makes the case that physical presence has something that is missing, and, yet. The genie is out of the bottle. We’re not going, you know, we’re not going to get rid of our telephones, and if I want to send a message, I write you a letter, or, you know, I send you a message with a boy – a runner – run and deliver – people would do that – we’re not going to be able to go back, so the challenge then becomes how to be authentic online and interact with a phenomenology of online presence with new forms of, I mean, in the world of online humor I’ve been known to say occasionally two new clients, I mean, well what about the digital divide. You need a computer and zoom and a door that you can close for confidentiality, and privacy. I’ve had clients, sadly at the beginning of the pandemic that fell through the digital divide. This young man was living in the same bedroom with his younger brother. He was trying to do the conversation, walking around outside. It was really hard. It was really kind of not working the way it should. And so there are peopling now where are you may need to meet with them in person, because they don’t have the technology. And here in the States, it’s a much bigger country (bold statement of the obvious) than Israel; in some ways, more poverty. There are parts of this country, which are not digitally wired and connected; and so those issues become a matter of social justice as well. And so I have to call them Sherry doesn’t solve them either, but nevertheless she lines up and makes the case that it’s very important. So where are we? I want to – maybe since I’ve got The Conch Shell here, I will tie up two loose ends. I interrupted myself as I was talking about her Memoir. After she answers up for a little while at the Committee on Social Thought and she ends up writing a dissertation at MIT on the social psychology of French political psychoanalysis. She meets Jacque Lacan – so all of the controversial figures Professor Bettelheim, Jacque Lacan – the amazing thing – I really want to put this on the video – he [Lacan] treats her nicely – bad [boy, Lacan] – I mean, Why? This is so uncharacteristic. Why? He wants her to write nice things about him. He wants her to produce a enriching and ennobling and even perhaps – you know, given who he is – a flattering report and she doesn’t of course do that but he does come to Boston to visit at Cambridge, and to visit the colleagues, and the thing about Lacan – the only criticism – the only problem with Lacan – there’s only one problem, Jacque Lacan. He goes to dinner. He doesn’t wear a tie. He throws a conniption fit. It’s kind of an interpersonal disaster. Professor – Sherry not yet Professor Turkle has nothing to do with his bad behavior but it resonates in different ways, She goes on to publish that book I was waving around or about to wave around [on camera] in this version Psychoanalytic Politics [on camera] you see the cover [and a silhouette] of protesters of May 1968 and the Eiffel Tower there. She is not a Lacanist, but she is informed by the dynamics, and, you know, the prohibition creates the desire. I didn’t know I wanted to go online to do therapy until you told me I couldn’t. Now if I have to explain the joke, it’s not funny. That’s the best I can do. So that wraps up her memoire. There’s a lot more there, but those are some of the essential talking points. So I pause for breath.
Arnon: It’s a nice way to finish with the more personal. May I bring up another personal [matter] – Sherry speaks so honestly about a Jewish home she grew up and her problematic father and she came to the same direction that I came to though I have a wonderful father, because he thought technology can help change the statues of the Jewish people. It can help solve the pandemia, the pandemic. It can help the human race. So my father really believed in technology, but not only in the technical aspects, but it’s a part of the human spirit that we can fix things. We can overcome problems,
Lou: That is remarkable, because here you are growing up in a Kibbutz, which is kind of a collective environment. The parents are not dismissed, but moved to the side and here Sherry who gets a lot of attention, in some ways it’s almost impossible to get too much attention but she does and not always of the right kind in some instances, and the end result is this complicated relationship with technology for the things that it is powerful in doing and for its disadvantages and drawbacks as well advantage. So final thoughts as we are coming up on the back end of our conversation. And your personal anecdote is a final thought. Two thumbs up on the work she’s doing. We find that we take exception to the throwing online therapy and online psychoanalysis under the bus as we say here in the States. The problem with that – here is my final reflection – the problem with that is that it is getting crossed under the bus. There are a lot of people under the bus struggling so we want to make productive useful application of all of the means to combat human suffering. What all of these different modalities have in common – whether it’s CBT or biofeedback or group therapy or traditional dynamic therapy or rigorous Freudian therapy or self psychology – they’re not exactly the same – all of these are commitment and a stand against human suffering which is significant and ongoing that’s my thought. So I think Sherry stands with that. I think we have common ground there.
Arnon: Yeah, maybe she would join us in the next go around
Lou: Well, would you like to make an invitation? Make the formal invitation, because that occurred at the start of the conversation.
Arnon: Well, you probably would say it in a more American, polite way – but I would say: Sherry, I was trying to communicate with you, she know it, so I wrote to her, because we wrote a book – we did not mention it yet – we wrote a book about online therapy with Haim Weinberg [editor] and you wrote a chapter – and I wanted to have her in the book – it was before she wrote the Empathy Diaries – and she wrote to me, I am so much into it [writing the memoire] that I cannot stop – and I pushed again – and being Israeli, I pushed, and she replied, “I appreciate it but no.” Maybe now she will be more open.
Lou: There’s an invitation for further conversation. Thinking of the end: we acknowledge your empathy, Professor Turkle – Sherry. I acknowledge your empathy, Arnon, my colleague and friend. I acknowledge the empathy of the listeners to this conversation, because you’re listening creates the empathy in this conversation. We honor and thank and acknowledge you for that. Thank you very much. Signing off.
(c) Lou Agosta, PhD, and the Chicago Empathy Project
Resistance to Empathy and How to Overcome it (Part 2): Individual Provider and Receiver (of Empathy)
Empathy is trending. As we engage with provider empathy, the pendulum has swung far enough for a backlash against empathy to be emerging.
Empathy with negative emotions and suffering is difficult. From a purely selfish perspective, empathic data gathering about the negative experiences endured and survived by other persons can be, well, negative. Negative experiences such as loss, hostility, intense rage, sexual danger, sadness, sleep deprivation, fear, and so on, are not welcome by anyone even as a less intense vicarious experiences. One fears getting the full-blown experience, not merely vicariously experiencing a sample or trace. The would-be empathizer is at risk of being overwhelmed, inundated, or flooded by emotional upset. The person’s empathy is on the slippery slope of empathic distress; and the empathy is at risk of breakdown.
The language is telling. If one is hit by a tidal wave, then one is going to be “under water.” Kick your feet, make swimming motions with the arms, and rise to the surface to try to catch your breath. While an empathic response is easier said than done, expressing the suffering of the survivor in a simple and factually accurate statement can open the way to containing the suffering and getting unstuck. Dial down empathic receptivity and dial up empathic interpretation and understanding.
People committed to providing empathy to other people resist their own commitment to empathy for several reasons. As soon as a person makes a commitment—in this case, a commitment to practice empathy—then all the reasons why the commitment is a bad idea, unworkable, unreasonable, or just plain absurd, show up. There is no time. It is too expensive. No one is interested. What seemed like a good idea yesterday, now seems a lot more challenging and like a lot more work. Yet empathy is never needed more than when it seems there is no possibility of it.
The would-be empathizer is vulnerable to a vicarious experience of the other person’s suffering. Indeed if one’s empathic data filter is not granular enough, one is at risk of being inundated by emotional contagion. This does not mean that the provider of empathy has to be a masochist, stuck on suffering. However, it does mean being vulnerable to a sample of the suffering. It does mean opening oneself up to a sample of the other person’s upsetting experience. It does mean being receptive to that which the other finds so upsetting, but doing so in a regulated and limited way. Hence, the need for training.
The training consists in interrupting and accepting one’s own feelings and letting them be. Practice is required in order to increase one’s tolerance and learn to be with uncomfortable feelings.
One key to forming a humane relationship with anyone who is upset: Vicariously getting a taste of the upset, experiencing vicariously the other’s fear or anger. Acknowledge the experience as valid. Accept the experience, not as good or fair, but as what one has indeed experienced.
One celebrity academic claims that in empathy the better part of emotion is reducible to emotional contagion. What the world needs to practice is not empathy, but rational compassion. As if one had to choose between the two! The world needs expanded empathy and more compassion of all kinds.[i]
A vicarious experience is essential data as to what the other person is experiencing; but if one is distressed to the point of upset by the other’s upset, then one is not going to be able to make a difference. Paradoxically one is not going to be able to experience one’s experience due to being distracted by one’s own upset. One’s empathy has misfired, gone off the rails, failed.
Empathy is in breakdown. One has to regroup. Take a time out. Acknowledge that one is human. One does not always get it right, but that does not mean that one is less committed to empathy or helping the other. It is worth repeating that the empathizer may expect to suffer, but not too much—just a little bit.
The good news is that empathy, when properly implemented, serves as an antidote to burnout or “compassion fatigue.” Note the language here. Unregulated empathy supposedly results in “compassion fatigue.” However, this work has repeatedly distinguished empathy from compassion.
Could it be that when one tries to be empathic and experiences compassion fatigue, then one is actually being compassionate instead of empathic? Consider the possibility. The language is a clue. Strictly speaking, one’s empathy is in breakdown. Instead of being empathic, one is being compassionate, and, in this case, the result is compassion fatigue without the quotation marks. It is no accident that the word “compassion” occurs in “compassion fatigue,” which is a nuance rarely noted by the advocates of “rational compassion.”
No one is saying, do not be compassionate. Compassion has its time and place—as does empathy. We may usefully work to expand both; but we are saying do not confuse the two. Empathy is a method of data gathering about the experiences of the other person; compassion tells one what to do about it, based on one’s ethics and values.
Most providers of empathy find that with a modest amount of training, they can adjust their empathic receptivity up or down to maintain their own emotional equilibrium. In the face of a series of sequential samples of suffering, the empathic person is able to maintain his emotional equilibrium thanks to a properly adjusted empathic receptivity. No one is saying that the other’s suffering or pain should be minimized in any way or invalidated. One is saying that, with practice, regulating empathy becomes a best practice.
However, the good news is sometimes also the less good news.
The other person’s suffering reminds one of one’s own suffering.
The other person’s anger reminds one of one’s own anger.
The other’s failures evoke one’s own setbacks.
The other’s self-defeating behavior is plainly evident to any third party, but one’s own self-defeating behavior seems to continue with regularity in tripping up oneself.
Rarely does a person say, “I want to be empathic in order to confront my own personal demons.” Rarely does one say it, but that is what is needed. That is the work of expanding one’s empathy. As in the fairy tale, one must spend three nights in the haunted castle, fighting the ghosts of one’s past and confronting the illusive specter of one’s blind spots.
Anxiety, depression, fragmentation, and the dehumanization dwelling in the dark side of human nature loom large before discovering the buried treasure of one’s own emotional resources in the face of upsets.
The thinking and practices that created empathy breakdowns are insufficient to overcome them. The thinking and practices that created resistances to empathy are insufficient to transform them. To get one’s power back in the face of resistance to empathy, something extra is required.
Expanding one’s empathy in the face of one’s own resistance to empathy requires something extra. Expanding empathy requires expanding authenticity, so the person who would practice empathy has to confront and clean up his own emotional contagion, conformity, projection, egocentrism, devaluing judgments and opinions, and the tendency of communications to get lost in translation. This clean up requires acting to repair disruptions in relatedness and repairing misunderstandings and miscommunications with other people by acknowledging one’s own contribution to the breakdown. It requires picking up the phone or requesting a meeting. It requires showing up, engaging, and acknowledging how one acted to cause the upset or breakdown.
Instead of emotional contagion, conformity, projection, and mistranslation, one enters the empathic cycle, engaging with openness towards the other person in receptivity, understanding of possibilities, taking ownership of one’s meaning making so that the other person is left free to be self-expressed, and responding in such a way that the other person is left whole and complete.
This means accepting the consequences of one’s deeds and mis-deeds. That is the first step—and every step—in recovering one’s power in relation to empathy. One might not get what one wants. However, what one is going to get is unstuck—and the freedom to be empathic in relationships going forward.
Everyone wants to get empathy, don’t they? Speaking of a recipient’s resistance to empathy sounds like resisting rainbows and colored balloons. What’s not to like? Empathy is what everyone really wants, isn’t it? Well, not always. Resistance to empathy—that it exists—is the basic empathy lesson of this chapter.
Emotional closeness leaves a person vulnerable to disappointment. The would-be recipient of empathy is ambivalent and vulnerable about being intimate with the other person, inhibiting the recipient’s empathic relatedness. The result is resistance to empathy.
People want approval from other people. People want approval for their opinions and behavior. People want agreement. Life is definitely easier, at least in the short run, if one is surrounded by people who agree with one rather than disagree.
People especially want agreement when they have something to be disagreeable about. They want agreement when they have a complaint. However, empathy does not lead off with approval and agreement.
Empathy leads off by being quiet and listening. In the face of chronic complaints and self-defeating behavior, being empathic often takes an open and inquiring stance that the other person may usefully take a look at any responsibility or potential blind spots he may be holding onto as the source of the complaint. It seems like “mission impossible,” since the blind spot is precisely that which, by definition, one does not know and that to which one can get access only through sustained self-inquiry. Doing the hard work of undertaking an inquiry into one’s own issues is, well, hard work. That results in resistance to empathy.
Resistant or not, people want to be understood. People want to be gotten for who they authentically are. People want other people to know how they have struggled to succeed and overcome adversity.
Yet, in hoping to be understood for who they really are, people are asking, not so much for agreement as for empathy.
People assert that they want to be understood; yet they do not want to be understood too well.
People do not want to take too close a look at how they have contributed to their own struggle and effort. People do not want to face directly how they have contributed in self-defeating ways to their own frustration and stuckness about which they so loudly complain.
People want the recognition of their humanity that comes with empathy; but not the unmasking of their own blind spots, which requires getting out of their comfort zone.
Let’s face it. People can be difficult. People are disagreeable. People are contrary. People are ornery. People are rude and discourteous. People push and shove. People often forget to honor their agreements. People lie. People are overly aggressive. People are overly sexed. People are under-sexed. People smell bad. Is it any wonder that people do not want to get close to other people? Is it any surprise that people develop resistance to being empathic towards other people?
This is a case of you can’t live with them and you can’t live without them. People, that is. Yet there is no such thing as a person in isolation. A person by himself is not a survivable entity. That is true of newborn babies. That is true of children of tender age, who require years of guidance and education. Likewise, that is true of adults, though in more nuanced ways.
The “I” is a part of the “we,” and the “we” a part of the “I”
Early prehistoric humans needed a companion to tend the campfire and stand guard against predators (or hostile neighbors) while the other(s) rested. The basic male and female pair was an inseparable requirement for procreative success.
Propagating the species to build a community against the ravages of infant mortality was a priority requiring skills to cooperate with one another socially. For most of recorded history (and before) children were the equivalent of a pension plan for aging parents; and in many parts of the world today that continues to be the case.
Domination and control of individuals in community based on physical strength and violence coexisted alongside (and contended against) forms of cooperation, leadership, and community-building based on the skillful use of language and symbols to exercise power based on motivation, persuasion, inspiration, inclusion, and enlightened self-interest.
The point is not to tell a “just so” story about the origins of civilization, but rather to acknowledge that, not only is the individual a part of the community, the community is also a part of the individual. This bears repeating. The “I” does not only belong to the “we”; but the “we” is a part of the “I.” We carry within ourselves a readiness for community, a readiness for relatedness, a sense of inclusion in community; and if there is no one else to talk to, we talk to ourselves.
The empathy lesson? Empathy is the foundation of relatedness, and resistance to empathy is resistance to relatedness. People are born into “relatedness.” Empathy is about participation with others. Empathy is about relatedness with other people and who these others authentically are in their strengths and weaknesses, in their possibilities and limitations. Even when a person is a hermit, all alone, he is alone in such a way that his aloneness depends on the basic condition of his being a creature designed for relatedness. Being unrelated is a privative form of relatedness; and being alone is a deficient form of relatedness. Paradoxically, nonrelatedness becomes a way of relating for some.
Given that resistance to empathy on the part of the would-be recipient of empathy is pervasive, what is the recommendation? Ask yourself: What is coming between myself and the other person who is offering empathy? Perhaps fear of being misunderstood is a factor. Fear of being let down is another factor. Fear of being vulnerable gets in the way. Fear of disappointment is a consideration.
What do all these factors have in common? Fear. Fear is front and center. However, there is something else further back behind the fear. Less obvious but highly significant. What would a person have to give up in order to be receptive to the gracious and generous listening being offered? Behind the fear is attachment—attachment to suffering.
Suffering is sticky
For people who are survivors, whether of the college of hard knocks or significant trauma, allowing themselves to experience another’s empathy takes something extra. Many people who fall short of a clinical label of “post traumatic stress disorder” (PTSD) have an area in their lives in which they are engaged with their suffering in an intimate way. You know the saying: “Keep your friends close, but your enemies even closer”? So it is also with suffering. In order to survive suffering, many people have decided to keep it close to them. They are attached to it. Overly attached? One thing is for sure. Suffering is sticky.[ii] Letting go of the suffering through the soothing experience of empathy seems like a risky proposition to people who feel fragile and vulnerable.
Consider PTSD. (We define our terms.) In an attempt to master the consequences of the life threatening experience of trauma, the organism (the human mind/body) keeps the fear, anxiety, and pain split off from being experienced as one’s own. Yes, one was present when the assault happened, the violence was perpetrated, or the train wreck occurred.
Yet in another sense, one was not present. One was not there, at least not as a conscious being. In being overwhelmed in the moment, one immediately took oneself out of the experience as an immediate reaction and survival mechanism. The traumatic experience remains unintegrated with one’s other life experiences, spinning in a tight circle of repetition.
The circle of repetition is split off from the person’s awareness and everyday life, remaining isolated—“sequestered” is the technical term for it.[iii] Suffering lives. The pain is real. Suffering itself becomes a kind of “comfort zone,” but only in the limited sense that it is isolated and separated from the awareness of the person trying to live his life.
This in no way diminishes the struggle or suffering of the survivor. Yet letting go of the suffering through the soothing balm of empathy shows up like a risky encounter with the unknown. For most people, the unknown itself is fear inspiring. The unknown is as fear inspiring as the suffering itself.
One keeps coming back to the suffering in the hope that it might be magically shifted. One keeps coming back to it like an exposed nerve in a toothache. Yes, it still hurts—ouch! The suffering starts to dominate one’s whole life, and one builds one’s life around the suffering, trying to manage and contain the uncontainable. One says, “I know my own dear little suffering up close, and it is a comfort to me in its own way—it gives me all these secondary gains—even though the impact and cost is staggering in the long term—yet I cannot let it go.”
We cycle back to empathy and its many dimensions in the context of suffering as an uncomfortable comfort zone.
How to be empathically responsive to the struggling individual and his “dear little suffering” requires an empathic listening of remarkable finesse and timeliness.
Empathy can help people get out of their comfort zone, in this case a place of suffering, in a safe and liberating way. When empathy gets an opening, empathy shrinks the trauma the way interferon is supposed to shrink tumors. Empathy sooths the accompanying suffering and reduces the stress.
The survivor is able to let go of the attachment to suffering, and engage with new possibilities. No guarantee exists that the outcome of the new possibilities will be favorable; many risks await; but the individual is no longer stuck.
In summary, we have engaged with resistance to empathy from three perspectives. We have explored overcoming resistance to empathy in the organization, in the individual providing empathy, and in the individual receiving empathy. In each case the empathy training consists in driving out obstacles to empathy, reducing or eliminating the resistance, so empathy can spontaneously grow and develop.
The organization drives out empathy by enforcing conformity to an extensive and contradictory set of rules, whose complexity is such that at any give time, the individual is technically (though unwittingly) in violation of one of them.
Speaking truth to power can be hazardous to one’s career; and humor is closely related to empathy; so humor becomes a powerful way of regulating empathy, expanding and contracting empathy in such challenging organizational contexts. Humor is a powerful tool against the arrogance of authoritarian domination. Both empathy and humor require crossing the boundary between self and other with integrity and respect, but humor offers additional opportunities for questioning the status quo, speaking truth to power, and creating the stress, suddenly relaxed by laughter, caused by expressing what’s so.
Empathy has a key role to play in organizations in reducing conflict, overcoming “stuckness,” eliminating self-defeating behavior, building teams, fostering innovation, developing leadership, and enhancing productivity. The empathy lesson is to use humor (and empathy) to undercut resistance to empathy in the organization. The lesson is that empathy is a source of creating possibilities, overcoming conformity through innovation, and leading from a future of possibilities.
Resistance to empathy on the part of those who provide empathy shows up as “compassion fatigue” and burnout. The word is a clue: compassion, not empathy, causes “compassion fatigue.” So much compassion, so little empathy. I hasten to repeat that the world needs both more compassion and more empathy. Peer group dynamics, collegial support, and self-care are required to recharge the emotional resources of those routinely providing empathy to others.
Regular self-care, including exercise, nutrition, quality time with family/friends, is on the critical path to survival and flourishing, managing the risk of experiencing empathic distress.
This makes the case for self-care and self-monitoring on the part of professionals of all kinds and first responders in health care, education, sales, leadership, public safety, customer service, and so on, whose empathy is a significant part of their role. Professionals take breaks and are on top of their empathy game; amateurs try to be empathic all the time (whatever that would mean), experience empathic distress, make it mean they lack empathy, and quit. Those who do not take care of themselves, then blaming empathy when they get burned out, are committing a kind of malpractice of empathic engagement (in the literal, not pejorative sense of the word). Like a helicopter, empathy is powerful and complex, so it requires regularly scheduled maintenance lest something go wrong at an inconvenient time.
For those individuals who want empathy or think that they want empathy, but then change their minds, resistance to empathy confronts readiness for empathy. Some people simply would rather not be understood. For them, being understood has resulted in bad outcomes. They have been manipulated, used, even abused.
In such cases, the would-be empathizer has to “dial down” empathic receptivity, in which the communication of affect looms large, and “tune up” empathic interpretation, in which one cognitively processes what it might be like to take the other’s point of view. Once a person feels safe, the person will be willing to risk exposing and exploring the vulnerabilities that got the person stuck in the first place and need working through to get the person moving again into a flourishing future of possibilities.
In conclusion, empathy is supposed to be like motherhood, apple pie, and puppies. What’s not to like? A lot. People can be difficult—very difficult—why should empathizing with them be easy? Yet most of the things that are cited as reasons for criticizing and dismissing empathy—emotional contagion, projection, misinterpretation, gossip, messages lost in translation and devaluing language—are actually breakdowns of empathy. With practice and training, one’s empathy expands to shift breakdowns in empathy to breakthroughs in understanding, possibilities of flourishing, enhanced humanity, relatedness, and building community.
[i] Empathy is now a major publishing event. There is a wave of books on empathy—popular, scientific, political, and scholarly. For example, Frans de Waal’s The Age of Empathy explores empathy between humans and higher animals; J.D. Trout’s The Empathy Gap considers empathy and social justice from the perspective of Ignatian Humanism; Jeremy Rifkin’s The Empathic Civilization, 800 pages long in hardcover (don’t drop it on your foot!) channels Teilhard de Chardin’s idea of a global consciousness, now including the politics of empathy; Jean Decety’s Social Neuroscience establishes correlations between sensations, affects, and emotions using functional magnetic resonance imaging technology (fMRI) as a kind of x-ray for the soul, exploring the relation between empathy and psychopathy (with his colleague Kent Kiehl); Simon Baron-Cohen’s Zero Degrees of Empathy considers the role of empathy in cruelty and disorders of empathy such as psychopathy and autism. Thomas Farrow’s (ed.) Empathy in Mental Illness drills down scientifically on the disorders of empathy in all their profound differences. See also: Susan Lanzoni, Empathy: A History (Yale 2018); any collectioin on social neuroscience by Jean Decety; William R.Miller, Listening Well: The Art of Empathic Understanding (WIPF and Stock, 2018); Cris Beam, I feel You: The Surprising Power of Extreme Empathy (Houghton Mifflin, 2018); Jodi Halpern, From Detached Concern to Empathy: Humanizing Medical Practice, (Oxford, 2001); David Howe, Empathy: What It Is and Why It Matters (Palgrave Macmillan, 2013); Leslie Jamisom, The Empathy Exams (Essays) (Graywolf, 2014); Thomas Kohut, Empathy and the Historical Understanding of the Human Past (Routledge 2021).
[ii] I discuss this proposition in detail in Lou Agosta. (2015). A Rumor of Empathy: Resistance, Narrative Recovery in Psychoanalysis and Psychotherapy. London: Routledge (Taylor and Francis): 53, 55, 117, 190.
[iii] Bessel van der Kolk. (2014). The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma. New York: Penguin Books.
A person can regulate his or her empathy up or down by crossing the street. The empathy lesson is that if you can cross the street to avoid the beggar, regulating your empathy down, then you can cross the street (as well as use other methods) to expand your empathy, regulating it upward. So don’t tell me that empathy cannot be dialed up or dialed down with practice. That’s the point: practice.
Crossing the street is what happened in another story with which many readers are already familiar. The story of the Good Samaritan, one of the parables of Jesus of Nazareth, tells of two people who crossed the street, and one who did not. In the story, a traveler was waylaid by robbers. He is left for dead by the side of the road. The first two persons—the Levite and the priest experienced empathic distress, and, crossed the street, passing by the victim.
The Samaritan, however, was not overwhelmed by the victim’s suffering. The Samaritan perceived the suffering; he had a vicarious experience of the suffering that did not over-stimulate him with suffering and cause empathic distress. The Samaritan saw a fellow human being; recognized the suffering humanity; and he decided to get involved.
Multiple empathy lessons are available here. First, to regulate one’s empathy, cross the street. This is an edgy and confrontational way of putting it, but it is literally accurate. Cross the street away from the neighbor to “down regulate” your empathy, and experience less empathic distress; and cross the street towards your neighbor to expand your empathy in the direction of creating an inclusive community of persons, who recognize the value of cooperation.
The empathy lesson is that the vicarious experience does not have to be overwhelming. Rather, with practice, one is able to shift one’s focus from suffering to neighborliness; one is able to shift one’s attention from suffering to making a difference and enhanced self-esteem, expanding community and shared humanity.
Crossing the street is not the only way to reduce one’s chance of empathic distress or responding empathically. One may imaginatively changes places with the survivor and reflect that one would want the other’s help if one were in a similar predicament. One may spontaneously and without thinking act impulsively to be helpful, because one’s upbringing has made such responsiveness a habitual practice. (I believe this was the case with the Samaritan.) One may reflect, “I am safe and the survivor is no danger to me and it is my turn to help out.”
Or, on the contrary, one may make a devaluing judgment such as “The guy deserved what he got.” Such a judgment would be inaccurate—and in this case it would literally add insult to injury—but such thoughts do occur among by-standers. The passers-by may have just been hard-hearted. One person’s empathy is another’s antipathy. The language speaks volumes.
The empathy lesson consists in distinguishing such a devaluing thought; acknowledging that thinking is profoundly different than acting and should not be confused with it. The empathy lessons is to take action coming from one’s authentic commitments to building community through empathy, not devaluing thoughts.
This story is an empathy lesson that also instructs us in the difference between empathy and compassion. The Samaritan’s empathy told him what the other person was experiencing; his compassion (and ethics) told him what to do about it.
This bears repeating: empathy tells one what the other person is experiencing; compassion (and ethics) tell one what to do about it.
We are usually taught to devalue the behavior of the Levite and the priest; and surely they do not win a prize. Yet in an alternative point of view, they were all-too-human. Seeing all that suffering embodied in the survivor, they just couldn’t take it. They succumbed to empathic distress.
They experienced a breakdown of their empathic receptivity, and were overwhelmed in a kind of instant empathy fatigue (not compassion fatigue).
In an alternative reading of the parable, the would-be rescuers dial down the granularity of their empathic receptivity, so as not to be too sensitive to the suffering, even as they get a sample of the suffering, which is needed to inform their humanity.
The Good Samaritan, who is a seemingly infinite source of insight, is called to his empathic neighborliness by the distress of the injured traveller. The traveller who had fallen among thieves and was beaten near to death creates the possibility of empathic community by his loss of human well-being. He has been reduced to a lump of suffering, broken, physical pain.
The Samaritan rescues the traveller; the traveller humanizes the Samaritan, calling him not just to the role of an altruist doing a good deed (though that occurs too), but to his possibility as a human being in relation to another fragile, suffering, dependent human being.
The stricken traveller, by his very being, gives the Samaritan his own humanness. This occurs precisely in making the Samaritan a neighbor in answering the question, “Who is one’s neighbor?” Such was the trick question that the Pharisees posed to Jesus, to which this parable is the response.
The Samaritan gives humanness to the distressed traveller in an intervention that defines them as part of the same community of fellow travellers—neighbors—on the road of life.
In an alternative retelling of the story suppose that the Levite and the priest were “natural empaths,” biologically predisposed to be sensitive to the pain and suffering of other people. They were endowed with a certain “delicacy of empathy,” and they feel the suffering of the world deeply. Perhaps too deeply. Some people report: “I am a natural empath—and I suffer because I feel the pain of others too acutely. I started out being empathic—but people took advantage of me—and even when they didn’t, I was just too empathic; I got overwhelmed with sensation and sucked dry—the result was burnout, compassion fatigue. Nice guys finish last—so do empathic ones.”
Thus, the lament of the natural empath.
Empathy becomes a burden, because the world is filled with so much suffering. Yet if the person uses avoidance to “down regulate” their empathy, the person feels guilty because the individual believes that what she is doing is unkind, thoughtless, lacking in fellow feeling, and—unempathic.
So the natural empath falls into a double bind, and her suffering seems inevitable. She is over-whelmed by too much openness to the suffering of the other person or over-whelmed by guilt at not living up to her own standards of fellow-feeling and ethics.
These statements imply that empathy cannot be regulated through training, albeit a training that goes in the opposite direction (from too much empathy in the moment to less empathy) than that required by the majority of people, who are out of touch with their feelings and need to “up regulate” their empathy. The empathy lesson for the natural empath is to be more flexible about her ethical standards, while attempting to tune down her empathic distress.
Some people are skeptical that “natural empaths” are all that they say they are. Natural empaths in their natural state assert that they feel overwhelmed and distressed by other people’s thoughts and feelings. I see no reason to doubt such statements. However, to some critics, a redescription of the natural empath asserts that the latter are “irritable” and “hypersensitive.”
Empathy is recognizing and understanding the other’s perspective and then communicating that understanding to the other person. Someone who is unwittingly, even helplessly, swept along by the other’s feelings is not really being empathic. Over-identification, not empathy?[i]
The way out of this apparent impasse is to consider that the natural empath does indeed get empathic receptivity right in empathic openness to the other’s distress, but then the person’s empathy misfires.
Whether the misfiring is over-identification, resulting in empathic distress, depends on the description and redescription. Standing on the sidelines and saying “Try harder!” is easy to do. Where is the training the person needs when they need it?
The recommendation regarding training? Most people need to expand their empathy; some people—natural empaths—need to contract (or inhibit) their empathy. Empathy regulation—learning to expand and contract empathy—is the imperative in either case.
Instead of complaining about being an overly sensitive natural empath (however accurate that may be) do the work of practicing empathy by “down regulating” one’s empathy in a given situation, transforming empathic distress into a vicarious experience. Instead of complaining about not being pre-disposed to empathy, get up and do the work of practicing empathy, which for most persons means “up regulating,” expanding their empathy.
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
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: 10.1037/0022-35126.96.36.1992; 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: 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
Adams, Tristam Vivian. (2016). The Psychopath Factory: How Capitalism Organises Empathy. London: Repeater Books.
Agosta, Lou. (1976). Intersecting languages in psychoanalysis and philosophy, International Journal of Psychoanalytic Psychotherapy, Vol. 5, 1976: 507–534.
____________. (1977). Empathy and Interpretation. Ph.D. Dissertation. Philosophy Department. University of Chicago.
____________. (1980). The recovery of feelings in a folktale, Journal of Religion and Health, Vol. 19, No. 4, Winter 1980: 287–297.
____________. (1984). Empathy and intersubjectivity in Empathy I, ed. J. Lichtenberg et al. Hillsdale, NJ: Lawrence Erlbaum Press.
____________. (2010). Empathy in the Context of Philosophy. London: PalgraveMacmillan.
_____________. (2011). Empathy and sympathy in ethics, The Internet Encyclopedia of Philosophy, a peer reviewed online resource: www.iep.utm.edu/emp-symp/[checked 01/19/2018].
_____________. (2013). A rumor of empathy in psychology (the movie): http://empathyinthe contextofphilosophy.com/2013/04/28/a-rumor-of-empathy-in-psychology/ [checked 2018-01-20 (caution: an extract space may be inserted due to line break(s))].
____________. (2014). A Rumor of Empathy: Rewriting Empathy in the Context of Philosophy. New York: Palgrave Pivot.
____________. (2014a). A delicacy of empathy: The many meanings of ‘sympathy’ in Hume, Psicologia em Pesquisa, 8 (1): 3–14. DOI: 10.5327/Z1982-12472014000 10002.
_____________. (2014b). A rumor of empathy: Reconstructing Heidegger’s contribution to empathy and empathic clinical practice, Medicine, Healthcare, and Philosophy, 17 (2): 281–292. DOI: 10.1007/s11019-013-9506-0.
______________. (2015). A Rumor of Empathy: Resistance, Narrative, Recovery in Psychoanalysis and Psychotherapy. London: Routledge.
____________ . (2016). Radio Empathy: Empathy: What It Is and Why It Is Important With David Howe: https://youtu.be/nUefHF2dt_Y [checked on 11/11/2017].
Angera, J. 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, 5(1): 1–26.
Antoni, M. H., Lutgendorf, S. K., Blomberg, B. (2011). Cognitive-behavioral stress management reverses anxiety-related leukocyte transcriptional dynamics, Biological Psychiatry, 2011, 15: 366–372.
Axelrod, David. (2015). Believer: My Forty Years in Politics. New York: Penguin Books.
Babiak, Paul and Robert D. Hare. (2006). Snakes in Suits: When Psychopaths Go To Work. New York: Harper Publishing.
Baron-Cohen, Simon. (1995). Mindblindness: An Essay on Autism and Theory of Mind. Cambridge, MA: MIT Press.
______________________. (2011). The Science of Evil: On Empathy and the Origins of Cruelty. New York: Basic Books (Perseus).
Basch, Michael Franz. (1983). Empathic understanding: a review of the concept and some theoretical considerations, Journal of the American Psychoanalytic Association, Vol. 31, No. 1: 101–126.
Batson, C. Daniel. (2012). The empathy-altruism hypothesis: Issues and implications in Jean Decety, ed. (2012). Empathy: From Bench to Bedside. Cambridge, MA: MIT Press: 41–54.
Battarbee, Katja and 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://fliphtml5.com/gqbv/uknt/basic %5Bchecked on 11/31 /2017].
Bazelon, Emily. (2012). Sticks and Stones: Defeating the Culture of Bullying and Rediscovering the Power of Character and Empathy. New York: Random House.
Black, David S., Steve W. Cole, Michael R. Irwin, Elizabeth Breen, Natalie M. St. Cyr, Nora Nazarian, Dharma S. Khalsa, and Helen Lavretsky. (2013). Yogic meditation reverses NF-kB and IRF-related transcriptome dynamics in leukocytes of family dementia caregivers in a randomized controlled trial, Psychoneuroendocrinology, 2013 March 38(3): 348–355.
Boyd, Robyn. (2008). Do people only use 10% of their brains? Scientific American, Feb. 8, 2008: https://www.scientificamerican.com/article/do-people-only-use-10-percent-of-their-brains/ [checked on 12/14/2017].
Breggin, Peter R. (1991). Toxic Psychiatry: Why Therapy, Empathy, and Love Must Replace the Drugs, Electroshock, and Biochemical Theories of the ‘New Psychiatry.’ New York: St. Martin’s Press.
Brunero, Scott, Scott Lamont and Melissa Coates. (2010). A Review of empathy education in nursing, Nursing Inquiry: Vol. 17, No.1, March 2010: 65–74.
Canfield, Jack, Sally Burbank, Terri Elders, and Amy Newmark. (2003). Chicken Soup for the Soul. New York: Soul Publishing (Simon and Shuster).
Carnegie, Dale. (1936). How to Win Friends and Influence People. New York; Simon and Schuster, 1981.
Carruthers, Peter and Peter K. Smith, eds. (1996). Theories of Theories of Mind. Cambridge: Cambridge University Press
Chiu, Tony, Ming Lam, Klodiana Kolomitro, and Flanny C. Alamparambil. (2011). Empathy training: Methods, evaluation practices, and validity, Journal of MultiDisciplinary Evaluation, Vol. 7, No. 16: 162–200.
Ciaramicoli, Arthur. (2016). The Stress Solution. Novato, CA: New World Library.
Cohen, Ted. (1999). Jokes: Philosophical Thoughts on Joking Matters. Chicago: University of Chicago Press.
Coke, Jay S., Gregory Batson, and Katherine McDavis. (1978). Empathic mediation of helping: A two-stage model, Journal of Personality and Social Psychology36(7):752–766. DOI: 10.1037/ 0022-35188.8.131.522.
Davis, Mark H., Laura Conklin, Amy Smith, and 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, No. 4, Apr 1996: 713–726.
Darwin, Charles. (1872). The Expression of the Emotions in Man and Animals. Chicago: University of Chicago Press, 1965.
Decety, Jean, ed. (2012). Empathy: From Bench to Bedside. Cambridge: MIT Press .
Decety, Jean and P.L. Jackson. (2004). The functional architecture of human empathy, Behavioral and Cognitive Neuroscience Reviews, Vol. 3, No. 2, June 2004, 71–100.
Decety, Jean, Chenyi Chen, Carla Harenski, and Kent A. Kiehl. (2013). An fMRI study of affective perspective taking in individuals with psychopathy: Imagining another in pain does not evoke empathy, Frontiers in Human Neuroscience, 2013; 7: 489; published online 2013 September 24. DOI: 10.3389/fnhum.2013.00489.
Dennett, Daniel. (1978). Beliefs about beliefs, Behavioral and Brain Sciences, 1, 568–570.
_________________. (1987). The Intentional Stance. Cambridge, MA: MIT Press.
de Waal, Frans B. M. (2009). The Age of Empathy. New York: Harmony Books (Random House).
Del Canale, Louis, V. Maio, X Wang, G Rossi, M. Hojat, and J.S. Gonnella. (2012). The relationship between physician empathy and disease complications: An empirical study of primary care physicians and their diabetic patients in Parma, Italy, Academic Medicine 2012, 87(9):1243–1249.
Dick, Philip K. (1968). Do Androids Dream of Electric Sheep? New York: Ballentine Books, 1981.
Doyle, Arthur Conan. (1890a). The Resident Patient in Sherlock Holmes: The Complete Novels and Stories: Volume I. New York: Bantam Books, 1986: 578–591.
__________________. (1890b). The Adventure of the Abbey Grange in Sherlock Holmes: The Complete Novels and Stories: Volume I. New York: Bantam Books, 1986: 881–890.
Dreger, Alice. (2016). Galileo’s Middle Finger: Heretics, Activists, and One Scholar’s Search for Social Justice. New York: Penguin Books.
Editors of the Encyclopaedia Britannica. (2013). Henry Havelock Ellis. Britannica On-Line: https://www.britannica.com/biography/Havelock-Ellis [checked on 11/-06/2017].
Ekman, Paul. (1985). Telling Lies: Clues to Deceit in the Marketplace, Politics, and Marriage, New York, W.W. Norton; (2003); (2003).
__________. (2003). Emotions Revealed: Recognizing Faces and Feelings to Improve Communi-cation and Emotional Life, New York: Henry Holt.
___________. (2008). Conversations With History: Paul Ekman. YouTube:
http://- http://www.youtube.com/watch?v=IA8nYZg4VnI %5Bchecked on 12/14/2017].
Ellenberger, Henri. (1970). The Discovery of the Unconscious. New York: Basic Books.
Ellis, Havelock. (1897/1915). Studies in the Psychology of Sex, Vol. II: Sexual Inversion, 3rd ed., Philadelphia, (1st Engl. ed., London, 1897).
Farrow, Tom and P. Woodruff, eds. (2007). Empathy and Mental Illness. Cambridge, UK: Cambridge University Press.
Forster, Michael N. (2010), After Herder: Philosophy of Language in the German Tradition. Oxford, UK: Oxford University Press.
Frank, Jerome D. and Julia B. Frank. (1961). Persuasion and Healing: A Comparative Study of Psychotherapy. 3rd ed. Baltimore: John Hopkins University Press, 1993.
Freud, S. The Standard Edition of the Complete Psychological Works of Sigmund Freud, XXIV Volumes. Translated under the guidance of James Strachey. Hereafter abbreviated as SE.
______. (1905). Three Essays on the Theory of Sexuality. SE, Vol. VII: 123–246.
______. (1912). On the universal tendency to debasement in the sphere of love (Contributions to the Psychology of Love II). SE, Vol. XI: 177–190.
______. (1912b). Recommendations to physicians practicing psycho-analysis: The dynamics of transference. SE, Vol. XII: 109–120.
______. (1913a). On beginning the treatment (further recommendations on the technique of psycho-analysis). SE, Vol. XII: 121–144.
______. (1913b). Zur Einleitung der Behandlung, Gesammelte Werke, VIII. London: Imago Press, 1955: 454–478.
Gallese, Vittorio. (2001). The ‘shared manifold’ hypothesis: From mirror neurons to empathy, Journal of Consciousness Studies, Vol. 8, No. 5-7, (2001): 30–50.
________________. (2007). The shared manifold hypothesis: Embodied simulation and its role in empathy and social cognition in Empathy and Mental Illness, eds. T. Farrow and P. Woodruff. UK, Cambridge University Press.
Gallese, Vittorio and Valentina Cuccio. (2015). The paradigmatic body: Embodied simulation, intersubjectivity, the bodily self, and language in Open MIND 14(T), T. Metzinger and J. M. Windt, eds. MIND Group. Frankfurt am Main: DOI: 10.15502/9783958570269.
Garbarino, James 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).
Gentry, William. (2016). Rewards multiply with workplace empathy, Businessolver: http://www.washingtonpost.com/sf/brand-connect/businessolver/rewards-multiply-with-workplace-empathy/%5Bchecked 12/14/2017 ].
Gentry, William and Todd J. Weber, Golnaz Sadri. (2007). Empathy in the workplace: A tool for effective leadership, Washingtonpost.com: http:// http://www.ccl.org/wpcontent/uploads/ 2015/04/EmpathyInTheWorkplace.pdf [checked on 03/31/2017].
Gladwell, Malcolm. (2008). Outliers. New York: Little Brown.
Golan, Ofer 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.
Goldberg, Arnold. (2011). The enduring presence of Heinz Kohut: empathy and its vicissitudes, Journal of the American Psychoanalytic Association, Vol. 59, No. 2: 289–311.
Gordon, Mary. (2005). The Roots of Empathy: Changing the World Child by Child. New York/Toronto: The Experiment (Thomas Allen Publishers).
Grandin, Temple. (1995). Thinking in Pictures. New York: Viking Press, 2006.
Gregory, Richard. (1968). Visual illusions in Perception: Mechanisms and Models: Readings from Scientific American, eds. Richard Held and Whitman Richards. New York: W.H Freeman: 241–251.
Gropnik, Alison, Andrew Meltzhof, and Patricia Kuhl. (2000) The Scientist in the Crib: What Early Learning Tells Us About the Mind. New York: William Morrow Paperback.
Hacking, Ian. (1995). Rewriting the Soul: Multiple Personality and the Sciences of Memory. Princeton, NJ: Princeton University Press.
___________. (1999). The Social Construction of What? Cambridge, MA: Harvard University Press.
Hadwin, J., Simon 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:1025826009731.
Halpern, Jodi. (2001). From Detached Concern to Empathy: Humanizing Medical Practice. Oxford: Oxford University Press.
Harcourt, Bernard E. (2015). Exposed: Desire and Disobedience in the Digital Age. Cambridge, MA: Harvard University Press.
Harley, Willard J. (nd). Marriage Builders: http://marriagebuilders.com/index.html [checked on 11/02/2017]
Harlow, Harry F. (1958). The nature of love, American Psychologist, 13, 673–685.
Hatfield, E., J. Cacioppo, and R. Rapson. (1994). Emotional Contagion. Cambridge: Cambridge University Press.
Heidegger, Martin. (1927). Being and Time, trs. John Macquarrie and Edward Robinson, New York: Harper Row, 1962. [Note: “H” refers to pagination in the original Niemeyer German edition.]
Hickok, Gregory. (2014). The Myth of Mirror Neurons. New York: W.W. Norton.
Hobson, Peter. (2002). The Cradle of Thought: Exploring the Origins of Thinking. New York: Macmillan.
____________. (2005). What puts the jointness into joint attention? in Joint Attention: Communication and Other Minds: Issues in Philosophy and Psychology, N. Eilan, C. Hoerl, T. McCormack, and J. Roessler, eds. Oxford: Clarendon Press: 185–204.
Hojat, Mohammadreza, M. J. Vergate, K. Maxwell, G. Brainard, S.K. Herrine, and G. A. Isenberg. (2009). The devil is in the third year: A longitudinal study of erosion of empathy in medical school, Academic Medicine 84 (9): 1182–1191.
____________________, Daniel Z. Louis, Fred W. Markham, Richard Wender, Carol Rabinowitz, and Joseph S. Gonnella. (2011), Physicians empathy and clinical outcomes for diabetic patients, Academic Medicine Mar, 86(3): 359–64. DOI: 10.1097ACM.0b013e3182086fe1
Howe, David. (2012). Empathy: What It Is and Why It Is Important. London: Palgrave.
Howick, Jeremy. (2011). The Philosophy of Evidence-Based Medicine, Wiley-Blackwell, 2011.
Iacoboni, M. (2005). Understanding others: Imitation, language, and empathy in Perspectives on Imitation: From Neuroscience to Social Science, eds. S. Hurly and N. Chater, Vol. 1: 76–100. Cambridge, MA: MIT Press.
_________. (2007). Existential empathy: The intimacy of self and other in Empathy and Mental Illness, eds. Tom Farrow and Peter Woodruff. Cambridge, UK: Cambridge University Press.
Irwin, Michael R. and Richard Olmstead. (2012). Mitigating cellular inflammation in older adults: A randomized controlled trial of Tai Chi Chih, American Journal of Geriatric Psychiatry, 2012 September, 20(9): 764–722.
Isaac, Mike 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/face book-russia-ads-.html [checked on Oct 15, 2017].
Jackson, Philip L., Andrew N. Meltzoff, and Jean Decety. (2005). How do we perceive the pain of others? A window into the neural processes involved in empathy, Neuroimage 24 (2005): 771–779.
Kahneman, Daniel. (2011). Thinking, Fast and Slow. New York: Farrar, Straus, and Giroux.
Kantor, Jodi and David Streitfeld. (2015). Inside Amazon: Wrestling big ideas in a bruising workplace: The company is conducting an experiment in how far it can push white-collar workers to get them to achieve its ever-expanding ambitions, The New York Times, August 15, 2015: https://nyti.ms/1TFqcOG [checked on 06/30/2017].
Katz, Jackson.(2013). Violence against women: It’s a men’s issue, YouTube: http://www.you tube.com/watch?v=KTvSfeCRxe8 [checked 01/23/2016].
Kaufman, David and Mark Milstein. (2013). Clinical Neurology for Psychiatrists, 7th ed. London: Elsevier.
Kohut, Heinz. (1959). Introspection, empathy, and psychoanalysis, The Journal of the American Psychoanalytic Association 7 (July 1959): 459–483.
___________. (1971). The Analysis of the Self. New York: International Universities Press. 1971.
___________. (1972). Thoughts on narcissism and narcissistic rage, Psychoanalytic Study of the Child, 27: 360–400.
___________. (1977). The Restoration of the Self. International Universities Press. 1977.
___________. (1982). Introspection, empathy, and the semi-circle of mental health, International Journal of Psycho-Analysis, 63: 395–407.
___________. (1984). How Does Analysis Cure? Chicago: University of Chicago Press.
Kramer, Peter. (1993). Listening to Prozac: The Landmark Book about Anti- depressants and the Remaking of the Self. Revised edition. New York: Penguin, 1997.
Krumie, Matt. (2016). Ten companies putting empathy into action, Cornerstone On Demand: https://www.cornerstoneondemand.com/rework/10-companies-putting -empathy-action [checked on 07/03/2017].
Krznaric, Roman. (2014). Empathy: Why It Matters, and How to Get It. New York: Perigree Book (Penguin).
Kundera, Milan. (1984). The Unbearable Lightness of Being, tr. Michael Henry Heim. New York: Harper Perennial.
Lear, Jonathan. (2006). Radical Hope: Ethics in the Face of Cultural Devastation. Cambridge, MA: Harvard University Press.
Lerner, Claire and Rebecca Parlakian. (2016). How to help your child develop empathy, Zero to Three: Early Connections Last a Lifetime: https://www.zerotothree- .org/resources/5-how-to-help-your-child-develop-empathy [checked on 06/26/20 17].
Levine, Madeline. (2012). Teach Your Children Well: Why Values and Coping Skills Matter More than Grades, Trophies, or ‘Fat Envelopes’. New York: Harper Perennial.
Maes, M. (1995). Evidence for an immune response in major depression: A review and hypothesis, Progress in Neuro-Psychopharmaclogy and Biological Psychiatry19: 11–38.
_______. (1999). Major depression and activation of the inflammatory response system, Advances in Experimental Medicine and Biology 461: 25–46.
Mann, Thomas. (1902). Buddenbrooks, tr. H.T. Lowe-Porter. New York: Vintage Books, 1961.
_______________. (1912). Der Tod in Venedig in Der Tod in Venedig und Andere Erzaehlungen. Frankfurt am Main: Fischer Bucherei.
______________. (1912a). Death in Venice, tr. Stanley Appelbaum. New York: Dover.
Marcopolos, Harry. (2010). No One Would Listen. New York: Wiley.
Marinoff, Lou. (2000). Plato, Not Prozac! New York: Quill.
McKee, Annie. (2016). If you can’t empathize with your employees, you’d better learn to, Harvard Business Review, November 16, 2016.
Milgram, Stanley. (1963). Behavioral study of obedience, Journal of Abnormal and Social Psychology. Vol. 67, No. 4: 371–378. DOI:10.1037/h0040525.
Miller, Geoffrey. (2000). The Mating Mind: How Sexual Choice Shaped the Evolution of Human Nature. New York: Anchor Books (Random House).
Morrison, James. (2014). DSM-5 Made Easy: The Clinician’s Guide to Diagnosis. New York: The Guilford Press.
National Geographic Staff. (2004). The Genographic Project, The National Geographic Society: https://genographic.nationalgeographic.com %5Bchecked 06/27/2017].
Nelson, Katherine, ed. (1989/2006). Narratives from the Crib. Cambridge, MA: Harvard University Press.
Olden, Christine. (1953). On adult empathy with children, Psychoanalytic Study of the Child, Vol. 8 [annual]: 111–126.
Olweus, Dan. (1973/1993). Bullying in School: What We Know and What We Can Do. London: Wiley/Blackwell.
Ozcan, C. T., F. Oflaz, and 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.
Pace, Thaddeus W.W., Lobsang Tenzin Negi, Daniel D. Adame, Steven P. Cole, Teresa I. Sivilli, Timothy D. Brown, Michael J. Issa, and Charles L. Raison. (2009). Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress, Psychoendocrinology, 2009, Jan: 34(1): 87–98.
Kathleen Parker. (2017). Welcome to the year of the groper, The Washington Post, November 17, 2017.
Parmar, Belinda. (2014), The Empathy Era: Woman, Business and the New Pathway to Profit, London: Lady Geek Press.
_________________. (2016). The most empathetic companies: 2016. Harvard Business Review, December 20, 2016: https://hbr.org/2016/12/the-most-and-least-empathetic-companies-2016 [checked on 06/30/2017].
Pavel, Thomas. (1985). Fictional Worlds. Cambridge, MA: Harvard University Press.
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-aggress- ion-prevent- bullying/ [checked 12/12/2017].
Pecukonis, E. V. (1990). A cognitive/affective empathy training program as a function of ego development in aggressive adolescent females, Adolescence, 25: 59–76.
Pigman, G.W. (1995). Freud and the history of empathy, International Journal of Psycho-Analysis, 76: 237–256.
Piper, Mary. (1994). Reviving Ophelia: Saving the Selves of Adolescent Girls. New York: Ballentine.
Plato. (no date (nd)).). Apology in Plato: The Collected Dialogues, ed. Edith Hamilton, Princeton: Princeton University Press (Bollingen Series): 3–26.
_____. (nd). Symposium in Plato: The Collected Dialogues, ed. Edith Hamilton, Princeton: Princeton University Press (Bollingen Series): 526–574.
_____. (nd). Theaetetus in Plato: The Collected Dialogues, ed. Edith Hamilton, Princeton: Princeton University Press (Bollingen Series): 845–919.
Prum, Richard O. (2017). The Evolution of Beauty: How Darwin’s Forgotten Theory of Mate Choice Shapes the Animal World – and Us. New York: Doubleday.
Prinz, W. (1990). A common coding approach to perception and action in O. Neuman and W. Prinz, eds., Relationships between Perception and Action: Current Approaches. Berlin: Springer-Verlag: 167–201.
Pollak, Yehuda and Raz Yirmiya. (2002). Cytokine-induced changes in mood and behaviour: Implications for ‘depression due to a general medical condition’, immunotherapy and antidepressive treatment, International Journal of Neuropsycho- pharmacology, (2002), 5: 389–399. DOI: 10.1017/S1461145702003152.
Rakel, David P., 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 , Vol. 41(7): 494–501.
Rasmus, Daniel W. with Rob Salkowitz. (2009). Listening to the Future, Hoboken, NJ: John Wiley Press.
Riess, Helen. (2013). The power of empathy, TEDxMiddlebury: https://www.youtube .com /watch?v=baHrcC8B4WM [checked on 03/23/2017].
____________, John M. Kelley, Gordon Kraft-Todd, Lidia Schapira, and Joe Kossowsky. (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: https://doi.org/10. 1371/journal.pone.0094207.
____________, 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; 27(10): 1280–1286. DOI: 10.1007/s11606-012-2063-z.
Rizzolatti, G. and M. Gentilucci. (1998). Motor and visual-motor functions of the premotor cortex in P. Rakic and W. Singer, eds., in Neurobiology of Neocortex. New York, Wiley.
Sandler, J. (1960). The background of safety, International Journal of Psycho-Analysis, 41: 352–356.
Satel, Sally and Scott O. Lilienfeld. (2013). Brainwashed: The Seductive Appeal of Mindless Neuroscience. New York: Basic Books (Perseus).
Segerstrom, Suzanne C. and Gregory E. Miller. (2004). Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry, Psychol Bulletin. 2004 July; 130(4): 601–630.
Selyuk, Alynia. (2017). Uber CEO apologizes over video of dispute with Uber driver. National Public Radio (NPR) All Things Considered: http://www.npr.org/2017/03/ 01/517988142/ uber-ceo-apologizes-over-video-of-dispute-with-driver [checked on 07/02/2017].
Slavich, George M. and Steven W. Cole. (2013). The emerging field of human social genomics, Clinical Psychol Science, 2013 Jul; 1(3): 331–348.
Spinelli, Ernesto. (2005). The Interpreted World: An Introduction to Phenomenological Psych- ology, 2nd Edition. London: Sage Publications.
______________. (2016). On existential therapy: A personal reflection on its defining features: https://www.youtube.com/watch?v=B 4rCuHpa5hE [checked on 12/10/2017].
Stolorow, Robert D. (2007). Trauma and Human Existence: Autobiographical, Psychoanalytic, and Philosophical Reflections. New York: Taylor and Francis.
________________. and George E. Atwood. (1992). Contexts of Being: The Intersubjective Foundations of Psychological Life. New York: The Analytic Press (Taylor and Francis).
Therrien, Mark E. (1979). Evaluating empathy skill training for parents, Social Work, Vol. 24, No. 5 (Sep 1979): 417–19.
Titchener, Edward Bradford. (1909). Lectures on the Experimental Psychology of the Thought-Processes. New York: Macmillan.
Tomasello, Michael. (2014). A Natural History of Human Thinking. Cambridge, MA: Harvard University Press.
Tutu, Desmond. (1999). No Future Without Forgiveness. New York: Doubleday.
van der Kolk, Bessel. (2014). The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma. New York: Penguin Books.
Von Bergen, Jr., C.W. and Robert E. Shealy. (1982). How’s your empathy? Training and Development Journal, November 1982: 22–28.
Vul, Edward, Christine Harris, Piotr Winkielman, and Harold Pashler. (2009). Puzzlingly high correlations in fMRI studies of emotions, personality, and social cognition, Perspective on Psychological Science, Vol.4, No. 3 (2009): 274–290.
Vygotsky, Lev S. (1934). Thought and Language, tr. E. Hanfmann and G. Vakar. Cambridge, MA: MIT Press, 1963.
Wikipedia Contributors. (no date (nd)). Barack Obama supreme court candidates, Wikipedia: https://en.wikipedia.org/wiki/Barack_Obama_Supreme_Court_candidates [checked on 06/12/17].
Wimsatt, William C. (2007). Re-Engineering Philosophy for Limited Beings. Cambridge, MA: Harvard University Press.
Wittgenstein, Ludwig. (1951). Philosophical Investigations, tr. E. Anscombe. London: Basil Blackwell, 1968.
Zaffron, Steve and Dave Logan. (2009). The Three Laws of Performance: Rewriting the Future of Your Organization and your Life. San Francisco: Jossey-Base.
Zaki, Jamil and Mina Ciskara. (2015). Addressing empathic failures, Current Directions in Psych-ological Science, December 2015, Vol. 24, No. 6: 471–476. DOI: 10.1177/0963721415599978.
Zaki, Jamil. (2016). Does empathy help or hinder moral action, The New York Times, December 29, 2016: http://tinyurl.com/gwmfpxp [checked on 01/06/20Zimbardo, Philip. G., C. Haney, W. C. Banks. (1973). Interpersonal dynamics in a simulated prison, International Journal of Criminology and Penology, Vol. 1: 69–97.
(c) Lou Agosta, PhD and the Chicago Empathy Project
The idea is that what people really want more than anything else is to be gotten for who they are – i.e., people want empathy. This is an unexpressed and undeclared commitment; and something of which most adults are only dimly aware until they get some and discover, “Oh, that’s really cool. It seems to work. May I have another?”
You know how in the world of high fashion grey is the new black? Well, empathy is the new love. This is not an exclusive either-or choice; and people still want to be loved too. Just not quite as much as they want to be gotten empathically.
People can get love from Hallmark Cards or from the Internet. There is really a glut in the market for this kind of love, and many issues remain with quality. Like any mass product, the quality is questionable. Really fine love remains a scarce commodity in the final analysis. Empathy is a relatively even rarer capacity in the market – though, truth be told, it is common to every mother (or care-taker) and a newborn child, every business person with satisfied customers, every educational student-teacher encounter, and every neighborly encounter in the community. An example of the intersection of love and empathy will be useful.
Bull Durham, the movie, is one my favorite Valentine’s Day shows of all time. This is because it succeeds in bringing together love and desire, affection and arousal, silly valentine style sentiment and sexual satisfaction. Also, it has a happy ending. It is not really about baseball, though you would not be crazy for thinking it is. A guilty pleasure? Perhaps. However, much more than baseball, this movie demonstrates powerfully that empathy is the new love.
In Bull Durham, the heroine, Annie Savoy (Susan Sarandon), explains that she believes in the Church of Baseball. There are 108 beads in a Catholic Rosary and 108 stitches in a baseball. Can this be a coincidence? She “chooses” one guy, a baseball player, with whom to consort—that is, hook up–during each minor league baseball season. Suffice to say, it makes a good adolescent fantasy.
The top two “hook up” candidates are Nuke LaLoosh and Crash Davis, the latter played by Kevin Costner. Crash is a talented catcher who never broke out from the minor leagues. He is given an extension and asked to play for one more season to “bring along” Ebby Calvin LaLoosh, who, it seems, is destined for the major leagues – The Show, as it is called. Nick named “Nuke LaLoosh,” for his powerful fastball, Nuke lacks control, and his 90+ miles an hour pitch is depicted as “beaning” the Big Bird type Mascot of the team. Funny.
The nick name, “Nuke LaLoosh” expresses an empathic understanding of who the person is and induces an experience with which the person leaves the viewer—powerful like nuclear energy but perhaps a tad out of control and about to blow up. Crash asks Annie: “Why do you get to pick?” Before making her choice of LaLoosh over Crash, Annie’s answer nicely outlines a position close to mine if one includes that she is choosing:
“Well, actually, nobody on this planet ever really chooses each other, I mean, it’s all a question of quantum physics, molecular attraction, and timing. Why, there are laws we don’t understand that bring us together and tear us apart. Uh, it’s like pheromones. You get three ants together, they can’t do dick. You get 300 million of them, they can build a cathedral.”
There’s something for everyone in this film. Suffice to say, Nuke desires any woman he can get his hands on. He is a real “Lil’ Abner” type. He does definitely not have the distinction “desire of desire,” and women are as opaque to him and he is opaque, period.
Annie provides the empathy lessons. Nuke lets himself be tied up by her up, tightly, as he is a big guy, in anticipation of a sexual adventure—and she paints his toe nails! Nuke doesn’t really “get it,” but he kinda likes it. This puts a certain “spin,” more like a slider than a fastball on female empowerment. The lesson includes learning to wait—presumably his fastball gets more controlled along with his bedside manner.
For Crash, the empathy lesson is that Annie is the ultimate unattainable object. She plays hard to get in the most authentic possible way. By freely withholding her desire—even though one suspects the desire lives in her. Crash knows he’s desirable—hey, he looks just like Kevin Costner. But she won’t give in, and unless she does so freely, it may be a power trip or a notch on someone’s pistole, but it’s not authentic sexual satisfaction. It’s barely even sex.
In addition, Crash’s challenge is that he has standards. Yes, he desires Annie, but more than that he desires her desire, which, unless freely given, just does not get the sexual satisfaction job done for him. When asked what he believes, he gives one of the great soliloquies on empathic love:
“Well, I believe in the soul, the small of a woman’s back, the hanging curve ball, high fiber, good scotch, that the novels of Susan Sontag are self-indulgent, overrated crap. I believe Lee Harvey Oswald acted alone. I believe there ought to be a constitutional amendment outlawing Astroturf and the designated hitter. I believe in the sweet spot, soft-core pornography, opening your presents Christmas morning rather than Christmas Eve and I believe I long, slow deep, soft, wet kisses that last three days.”
Such kisses require empathy. Crash is frustrated in his desire because he longs to unite his desire with his affection for Annie and receive hers and her desire in return. I tell you, you cannot “get” this movie without the distinction “desire of desire,” which it so eloquently exemplifies. So when Crash does finally unite desire and affection in uniting with Annie and her desire of his desire, it makes for a happy ending. Everyone in the film reconciles desire and affection, and Nuke gets control over – premature ejaculation – oops, I mean, his fastball.
If empathy is the new love, what then was the old love? A bold statement of the obvious: the old love is akin to a kind of madness. The one who is in love is hypnotically held in bonds by an idealization by the beloved. In one way, love presents as animal magnetism, a powerful attraction; in another way, in a quasi-hypnotic trance, love idealizes the beloved, and, overlooks the would-be partner’s shortcomings and limitations.
According to Nobel Prize winning novelist, Gabriel Garcia Marquez, love is akin to a physical illness, cholera. In Marquez’s Love in the Time of Cholera (1985), also a major motion picture, the mother of Florentino Ariza treats his love sickness for the inaccessible Fermina Daza with the kinds of herbs used to relieve the diarrhea of cholera. Key term: inaccessible. The inaccessible object—whether the mother who is already married to the father or the girl next door whose family is feuding with one’s own—arouses one’s desire to a feverish pitch.
Note that in Spanish and English cólera and choleric, respectively, denote an emotional upset, expressing irritability and a kind of manic rage, hooking up with Plato’s definition of love as madness. In a diverging register, in Saint Paul, love is God, love is community, and love is neighborliness. According to Bob Dylan, now also a Nobel Prize winner, “love is just another four letter word.” No sublimation here. Just hormones all the way down; though, to Dylan’s credit, he did not claim or publish the song as his own after Joan Baez made it famous.
According to Freud, love is aim-inhibited sexuality. When sexual desire is unable to attain its goal, which, by definition, is sexual satisfaction, the desire undergoes a transformation. The desire turns away from reality and expresses itself in fantasy. The desire becomes articulate. It learns to speak. It expresses symbolic statements of romantic dalliance and even love poetry. It lives on in the hope of recovering the erotic dimension as when, in Cyrano De Bergerac, Roxanne invites Christian to mount up the balcony to get a kiss. Cyrano is in love, and his love makes him blind – as in the stereotype – to the spoiled-princess-like behavior of Roxanne and the arrogant narcissism of Christian.
The celebrated Athenian “bad boy,” Socrates (c. 470 BCE – 399 BCE), famously said, “I know that I know nothing”; but then it turned out that he did know something after all, though only as a kind of myth (but what kind of knowledge is a myth?), and he distinguished four kinds of madness, the last of which is love:
“And we made four divisions of divine madness corresponding to four gods: to Apollo we ascribed prophetic inspiration, to Dionysus mystic madness, to the Muses poetic afflatus; while to Aphrodite and Eros we gave the fourth, love-madness, declaring it to be the best” (Phaedrus: 265).
The Symposium, a drunken party with Socrates and friends, as told by Plato, painting by Anselm Feuerbach
Due to a sin of pride, the gods punished these spherical humans by dividing them into two—which results in the present predicament of separate male and female human beings, as we know them today. The two halves are incomplete; and each wants to be reunited—and completed—by the other half.
We speculate that the division into male and female is not the only division. The separation of desire and affection is also a source of struggle, but about that Aristophanes has nothing to say.
The novelist Stendhal (1743–1842) said that beauty is the promise of happiness, but he got the idea from Aristophanes. Beauty is the promise of happiness experienced as the felt attraction between the two halves of the original spherical creatures. Thus, fast forward to the current predicament of humanity (and Match.com) with the two parts running around trying to hook up like crazed weasels, or, at least, attempting to get a date with that “special someone.”
In summary, the old love is a kind of madness; it makes a person blind, and causes somatic distress. So far the old love is indistinguishable from tertiary syphilis!
Let us be clear that no one is proposing an either/or choice between love and empathy. These two phenomena have existed and coexisted together since the beginning and will continue to do so. Granted that in the English language the history of the distinction “empathy” was covered by diverse meanings of the word “sympathy,” but, in any case, it goes way back.
My proposal is that love contains an empathic core in its stimulating and exciting aspects and that which is the “love sickness” part is due, well, to the struggle to unite affection and desire. In particular, that which is the “love sickness” is due to a breakdown in empathy.
The goal in love is to erase, at least temporarily, the boundary between the self and other. Merger of both mind and body with the other mind and body is the result. In contrast to love, empathy navigates or transgresses the boundary between self and other such that the integrity of the self and other are maintained. One has a vicarious experience of the other—but the difference and integrity of the self and other are maintained. So love emerges as a breakdown in empathy—from the perspective of too much or too little engagement with the other. It is love versus empathy. Yet in love, empathy lives.
In the examples of Annie and Crash Davis, the love-madness described by Socrates, the connection between Aristophanes’ spherical halves, the attraction, is a kind of magnetism—animal magnetism, to be precise.
In attraction Jeopardy, “animal magnetism” is the answer; what then is the question? How does a vicarious experience of someone else’s desire show up? A desire of desire? If we let our empathic receptivity inform our experience, stage one of the intersection of empathy and love can be redescribed as animal magnetism.
Simply stated, such animal magnetism is what you get when two lovers stare semi-hypnotically into one another’s eyes. Speaking from the guy perspective, to really turn on a woman, a guy has to get in touch with his inner female. He does not have to tell his softball buddies about this, but in the language of the Kama Sutra such a guy turns out to be worth his weight in diamonds. This is especially so if he sees value in getting in touch with his inner female, by practicing cooking and changing diapers.
When empathic receptivity shows up, can empathic understanding be far away? In this case, the empathic possibilities are rich and rewarding, but since this is not a book on sex tips and techniques, the reader is referred to resources for empathic possibilities in the above-cited realm of the sexual expression of love that are more eloquent—and better illustrated—than I could possibly provide here. Same idea with empathic interpretation, in which role-playing is a significant opportunity.
We feel chemistry with some people and not others because our empathic receptivities, understandings, and responses are aligned. We are able to fit the other person into the narrative we tell ourselves about what we are seeking in a partner.
The other person fits into our imagination in a role we assign, imaginatively, and the person is a good enough fit that they are willing and able to play the role assigned. Notice this means that the “love” part is the aspect that is the most problematic. If she “gets it” that he is good “boy friend” material—he has a nurturing side that will make him a good father—but this turns out not to be accurate, because he is a spoiled child himself, then it was love’s idealizations and wishful thinking, a breakdown of empathy into projection, not authentic empathy. On the other hand, if the initial empathy is accurate, it paves the way for love and empathy to enhance each other mutually in creating the community called a family.
The empathy lesson is that people are sometimes what they appear to be, but that sometimes appearances are misleading. This explains the common sense lesson that you need to talk to someone and listen to them before making serious commitments of the heart, of one’s finances, or of one’s time and effort. People come in all different shapes and sizes. Aristophanes’ joke gets the last word and lives on because the original spherical beings were in all different shapes and sizes before they were cleaved in two. People complete one another in different ways. After all the categories, labels, diagnoses, arguments, and projections are removed; empathy is being in the presence of the other spherical being without anything else added.
Ron Shelton, (1998), Bull Durham, the movie.: https://www.moviequotedb.com/movies/bull-durham/ratings.htmlquote checked on 02/13/2021. Staring Susan Sarandon, Kevin Costner, and Tim Robbins.
Lou Agosta, (2018), Chapter 9: Empathy Application: Sex, Love, Rock and Roll – and Empathy in Empathy Lessons. Chicago: Two Pairs Press. Order book here: https://shorturl.at/agCY9