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Empathy in the age of the coronavirus

What does empathy in the age of coronavirus look like? Two words to get started: social distancing.

Social distancing makes sense and is necessary; but social distancing has a cost and an impact.

No hugs allowed. No shaking hands. Bumping elbows? Questionable. “Hug therapy”? There is such an innovation, as the right kind of hug seems to release endorphins – but it is on the ropes. Not good news, though perhaps only a temporary – months long? – setback.

Do not overlook the obvious good news. Some jobs can be performed remotely using

Follow medical doctor's orders - keep calm - and wash your hands!

Follow medical doctor’s orders – keep calm – and wash your hands!

online methods and Skype-like facilities such as Zoom or Signal. Many businesses already operate secure virtual  private networks. Many kinds of consulting, coaching, guidance, and talk therapy can occur via telecomm, and, though aspects of empathic relatedness may be lost or stretched thin, good enough results can be attained to make it worthwhile to try. Other situations are more problematic.

The social distancing recommendation is strained to the breaking point when it comes to first responders such as doctors and nurses (police, fire, ambulance drives, and others).

Yes, one can take a throat and nose swab without too much interaction, but it is not going to happen from six feet away. Moreover, one does not know what is the cause of the patient’s symptoms so further “laying on of hands” is often required. Thus, the risk. I acknowledge that it is deeply cynical, but I have to note: “Just because we have a germ phobia does not mean we cannot get sick.” We can – and do.

Here the empathy lesson is that empathy is a two way street and the first responders may require reasonable accommodation – and empathy from the community including the patients. So if the doctor shows up in a HAZMAT [hazardous materials] suit, it is not for lack of empathy, it is due to needing to screen dozens of people and stay healthy to screen even more. See above on the cost of social distancing.

What to do when there are no masks and gowns, or MDs and nurses are asked to wear yesterday’s contaminated stuff, are the tough questions. Some hospitals (and families), who have fabrication (including sewing) skills, are making their own. Others are calling the media and blowing the whistle on this appalling situation of first responders at unnecessary risk. All are madly rushing about trying to close the barn door now that the horses [of the apocalypse?!] have escaped. [Update: paragraph added: 03/21/2020.]

Once again, empathy is about community and responsibility. Here is the empathic moment according to celebrity MD, Sanjay Gupta:

“How I behave affects your health. How you behave affects my health,” Gupta said on the air with CNN. “Never, I think, have we been so dependent on each other, at least not in my lifetime, and we should rise to that occasion.” [Kate Shepard and Allison Chiu reporting The Morning Mix March 18, 2020: ‘I’ve never seen Dr. Sanjay Gupta like this’: Strollers, joggers in locked down San Francisco spark anger on CNN: https://www.washingtonpost.com/nation/2020/03/18/coronavirus-cnn-sanjay-gupta/ ]

UPDATE: March 22, 2020:

University of Chicago Medicine infectious diseases expert Dr. Emily Landon spoke during the Illinois governor’s COVID-19 press conference on March 20, 2020. Hear her explain why the statewide order to stay at home is crucial to protecting everyone.

“Our health care system doesn’t have any slack. There are no empty wards waiting for patients or nurses waiting in the wings. We barely even have enough masks for the nurses that we have. Looking back to the last time, we were– limited tools and having a dangerous infection spread quickly was the beginning of the 1918 pandemic.

“Two cities in America made different choices about how to proceed and when only a few patients were affected. St. Louis shut itself down and sheltered in place. But Philadelphia went ahead with a huge parade to celebrate those going off to war.

“A week later, Philadelphia hospitals were overrun. And thousands were dead, many more than in St. Louis. This is a cautionary tale for our time. Things are already tough in Illinois hospitals, including mine. There is no vaccine or readily available antiviral to help stem the tide.

“All we have to slow the spread is social distance. And if we let every single patient with this infection infect three more people and then each of them infect two or three more people, there won’t be a hospital bed when my mother can’t breathe very well or when yours is coughing too much.” Do your part – follow Dr Landon’s guidance. Meanwhile –

You have got to get the black humor here. The situation in Washington DC (and on CNN) is serious but not hopeless; the situation in Milan, Italy, is hopeless but not serious – people under lock down as the death toll rises are going out onto their balconies and singing.

The mother of an eight grader in New Rochelle, New York, who comes home with a fever, is leaving trays of food outside his bedroom door and everyone is eating off of paper plates. This is what empathy looks like in the age of the coronavirus.

This is not a Saturday Night Live (SNL) skit. Six guys in HAZMAT [hazardous materials] suits descend on the family in New Rochelle and make them sign an agreement to stay home for two weeks. They signed. It could be worse. This too shall pass, and presumably the kid (whose fever is going down) will have enhanced (if not unconditional) immunity and can himself serve as a first responder once he grows up.  [See Jason Riley’s Report from New York’s Containment Zone March 17, 2020: https://www.wsj.com/articles/report-from-new-yorks-containment-zone-11584485597?cx_testId=3&cx_testVariant=cx_2&cx_artPos=3#cxrecs_s.%5D

Well and good, except where’s the empathy?

Empathy is all about boundaries and crossing boundaries with understanding, receptivity, responsiveness, respect, dignity, courtesy, humor (when appropriate), affection, affinity, and, at the risk of circular reasoning, empathic relatedness.

So what are the proper boundaries in a coronavirus epidemic? Empathy lessons 101 teach us that the most fearsome thing is the unknown – the Hold that thought. The unknown is stressful. The unknown leaves one feeling isolated. The unknown inspires anxiety. The unknown creates an opening for alternative facts, half truths, and total nonsense.

As noted in this blog previously, you know how in the vintage black and white monster movies, once the audience actually sees the Swamp Thing, which is obviously a guy in a lizard suit, it is a lot less scary? The creature may still be disgusting, but it is no longer nearly as scary. The scary part is when the heroine is innocently combing her hair and the swamp thing (which is “off camera” and the audience cannot yet see) is silently sneaking up behind her.

Doubtful this is the Zombie Apocalypse, but it puts me in mind of that U2 classic “Mysterious Ways”: “We’ll be living underground. Eating from a can. Runnin’ away from what you don’t understand. Love.” [Insert dramatic base line here.]

All right, so we are not yet ready for the Zombie Apocalypse, but some people are acting like it – like Zombies, that is. Especially unfortunate is that a few of them hold high public office or are media personalities. But we have got to work with what we’ve got for the time being. Other people are totally “business as usual.” Both extremes need to cut that out! Instead think! Think:  community and responsibility.

I am inspired in this thought – community and responsibility – by Jason Bridges. From a practical point of view, Jason Bridges, a professor of philosophy of mind and of Ludwig Wittgenstein (University of Chicago), writes eloquently in an unpublished but widely circulating email of community and responsibility in the time of coronavirus:

“Crises like this lay bare what is always anyway true: we are all members of community. To belong to a community is to be responsible for it” (Unpublished email 2020).

Though Bridges does not use the word “empathy,” this is the empathic moment. Those of us who are not at an especially high risk may usefully ask: “Is doing this responsible?” (“This” being many forms of in-person social contact we have taken for granted.)

The issue – and conflict – is that empathy is supposed to bring us closer –emotionally and spiritually. However, given the kind of physical embodied creatures that we humans are, emotional and spiritual closeness are often mediated by physical, bodily closeness (though crucially not always). (See above – back to “hug therapy.”)

We seem intrinsically to be a species that likes to congregate and get close to one another, at least on many occasions. Some cultures – Italian, Spanish, French, Southern (?) – seem to do this more so than others – Scandinavian, German, Northern (?). America, China, and Russia are vast and include some of each.

Thus, we return to the crucial issue of social distancing and its impact – and cost – with an illness spreading through community contagion.

By cancelling in person events at church, work, school, sports, theatre, and so on, in order to save lives, one is doing exactly the thing predicted to expand loneliness, isolation, detachment, and risking irrational behavior such as hording and opportunistic price increases. You solve one problem; create another. That’s another reason this is a crisis – the dominoes are still falling.

You see the dilemma? Going to church is not usually regarded as an intrinsically empathic activity, but lots of people do it because the experience of community addresses their need for empathy, to be acknowledged as a whole person, to feel included. Same idea with other community events.

Research shows that loneliness can be as bad for one’s health as smoking cigarettes or obesity (see John Cacioppo, (2008), Loneliness, Human Nature, and the Need for Social Connection, New York: W. W. Norton). Loneliness causes stress, reducing the immune system response, and triggering inflammation. Fear also causes such an immune response decline; and, heaven knows, the unknown – including aspects of the COVID-19 situation – is the most fearsome thing. So here is the rock and here is the hard place – what is one to do?

Just doing some brain storming here. The line at the polling station during the March 17, 2020 election had people waiting six feet apart. The frozen custard shop was reconfiguring its service line with markers on the ground at six-foot intervals. Given that the store is often jammed with children pushing forward, it is going to be interesting to see how that works.

Tips and techniques for maintaining and expanding social contact include: pick up the phone and talk to someone. Do not merely text, but have a conversation. Same idea using video conferencing such as Skype, Zoom, or Signal. Talk with one or two friends a day –once again, talk, not text. Do something for someone. It does not have to be volunteering to get the first coronavirus vaccination human trials, and dealing with the uncertainty whether it will cause your children to be born with tails. Do something small. Make a trip to the store for the senior couple next door. Help with chores, homework, or whatever you can contribute.

Although exercise and mindfulness do not usually require talking with others, they can be done in such a way that social distancing is maintained – for example, running outdoors or sitting indoors in a spacious room. These reduce loneliness and related stress.

I will not further comment on the detailed recommendation as numerous resources are available from WHO and the CDC (other relevant local authorities should be included here), frequently updated as we learn more and more about what to do or not to do. I accept the guidance and so should you, dear reader.

Now I agree events need to be cancelled due to the risk of community contagion. What I am asking is whether, for the time being, people can get their head around sitting two sneezes distance apart (in accordance with present CDC guidelines) and the pastor holds two services – one for seniors and one for those less at risk. More work? Yes, but perhaps doable just the same. (Okay, “two sneezes” means the six

Seems like the right idea to me for so many reason. Artistic activity boosts the immune system? Might be worth a try, though tragically the local Italian newspapers are crowded with obituaries. The hypothesis is that the warm, affectionate, cultural practices of getting in close for conversation and food and Catholic mass and so on, did not work well, rapidly spreading a highly contagious pathogen. No good deed goes unpunished!? Yet good deeds in abundance are many and even more are needed.

So, once again, what does empathy in the time of coronavirus look like?

As noted, it also looks like the Italian people, who are suffering severe fatalities in the pandemic, getting out on their balconies and singing – serenading the neighborhood.

It looks like maintaining a healthy routine of exercise, diet, communicating at arms lengths and with electronic media, keeping calming and carrying on – I mean – washing your hands.

It also looks like young healthy people making grocery shopping runs for senior citizens who are still healthy but reluctant to venture out. It looks like shoppers buying two cartons of eggs and two packages of toilet paper instead of two dozen.(What were these people thinking? Right, they were not thinking – that is the point – as Hannah Arendt noted long ago, not thinking can provide an opening for evil to get a foothold.)

It also looks like employers keeping staff on the payroll even though business is in a downturn.

It looks like insurers forgoing their monopoly rents and agreeing to reimburse first responders for their services in treating all potential patients without condition or qualification.

It also looks like government support for big pharma, which has a chance to shine [for a change!], in developing a vaccine (and anti-viral treatments) on a crash, moon-shot-style basis, which vaccine, in turn, has to be given-away to the planet.

Paraphrasing Jason Bridges, crises like this lay bear the weakness and strengths of the community. It puts me in mind of the kid’s game “The Cooties.” Some seven-year-old yells “You’ve got the cooties!” It is the game of tag. The kids all runs around like crazy playing tag – the opposite of social distancing, yet a transformation of it – because you cannot get close or you might be “tagged.” Fortunately, no one dies of the cooties, unlike COVID-19. Thus the breakdowns of empathy of the community are exposed – hoarding, stigmatizing, opportunistic behavior, boundary violations, beggar thy neighbor behavior.

Never was it truer that good fences (not walls!) make good neighbors; but there is a gate in the fence and over the gate is inscribed the word “Empathy.” Every breakdown, when handled with empathy, has the possibility of a breakthrough – a breakthrough in sustaining and crossing boundaries with expanded understanding, generosity, humor (as appropriate and inappropriate), responsiveness, receptivity, respect, random acts of kindness, dignity, and our shared humanity.

© Lou Agosta, PhD and the Chicago Empathy Project

 

Top 10 Trends in Empathy for 2020

10. Empathy is the new love. You know how in fashion gray is the new black? Same idea. Empathy is the new love. What people really want is to be “gotten” for who they authentically are as a possibility. In hoping to be understood for who they really are as a possibility, people are not asking for love; they are asking for empathy. If empathy is the new love, what then was the old love?

According to philosophers and poets, the old love is akin to a kind of madness—sometimes divine madness, sometimes just plain earthly madness. The one who is in love is semi-hypnotically held in bondage by an idealization of the beloved. In one way, love shows up as animal magnetism, a powerful attraction; in another way, in a quasi-hypnotic trance, love idealizes the beloved, and, blindly and madly overlooks the would-be partner’s failings and limitations.

Moutain path with sign in Rocky Mountain National Park

Mountainous empathy paths ahead for 2020 with sign in Rocky Mountain National Park

Folk wisdom, as noted, suggests that love is blind; Bob Dylan, that love is just a four letter word; Plato, that love is a kind of madness. So far, love sounds like tertiary syphilis.

The goal of love is to erase the boundary between the self and other. Merger of one’s mind and body with the beloved’s mind and body is the sought after result. In contrast to love, empathy navigates or transgresses the boundary between oneself and other such that the merger is temporary and 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 preserved.

So from the relational perspective of too much or too little merger and engagement with the other person—love shows up as a breakdown in empathy. It is now love versus empathy. In contrast with empathy, love is a boundary transgression, but one that is permissioned, invited, welcomed. Thus in empathy one creates a space of acceptance and toleration in which love lives.

  1. Empathy and politics: this is an election year in the USA. Politics in this age of polarization is characterized by bullying. How does empathy speak truth to power?

How to deal with bullying without becoming a bully? Set firm limits – set firm boundaries – thus far and no further. Being empathic does NOT mean giving up the right to self defense.

Still, without naming any names, the problem with mud wrestling with a pig is that everyone gets dirty – and the pig likes it! No easy answers here. One modest proposal:

Empathy is the emotional equivalent of jujitsu – use the aggressor’s energy to send him flying the other way. Being empathic does not mean being nice, agreeable, or even being disagreeable. It means knowing what the other person is experiencing because one experiences it too as a sample or trace affect.

As discussed further below in the trending one-minute empathy training, drive out cynicism, aggression, polarization, bullying, and the result is that empathy spontaneously comes forth, expands, and develops.

Power and force are inversely proportional. As the bully’s power goes down, the risk of the use of force [violence] increases. Empathy is powerful, and if necessary it meets force with force. But then it is no longer an empathy; it is empathy in the form of a breakdown of empathy. Empathy consists in restoring the boundaries and integrity to the situation.

  1. Empathy, capitalist tool: Empathy is the ultimate capitalist tool: No business or enterprise can operate for long, much less flourish, without empathy to facilitate teamwork, coordination between customers and sales persons, employees and employers, leaders and staff, and stake-holders at all levels. Even the cynical sales person understands the value of taking a walk in the customer’s shoes, if only to sell him another pair.

Unfortunately, business leaders lose contact with the human dimension of business in solving legal problems, meeting information technology breakdowns,  reacting to the competition, or dealing with the latest accounting crisis.

Yet empathy is never needed more than when it seems there is no time for it.

Sometimes leaders don’t need more data, leaders need expanded empathy. I hasten to add that, ultimately, both empathy and data are on the path to satisfied buyers, employees, and stakeholders. If the product or service is wrappered in empathy, has an empathic component as part of the service level agreement, gets traction in the market, and beats the competition’s less empathic competing offering, then we have the ultimate validation of empathy. “CEO” now means “chief empathy officer.” We do not just have empathy. We have empathy, capitalist tool.

7. Your brain on empathy: “It’s all in your head” is a necessary truth, but not in     the sense that you are imagining your experience of joy, fear, anger, pain, or suffering. It’s in your head because it—your experience—is in your brain, that is, your nervous system. We are neurons “all the way down.”

A word of caution. This scientific discovery of mirror neurons and mirroring phenomena should be distinguished from the neurohype occasioned by the application of the functional magnetic resonance imaging machine (fMRI) to issues that extend from the pseudo-disciplines of neuro-law to neuro-aesthetics to neuro-marketing and even neuro-history.

Show a jury in court a picture of a person’s brain and it gives the argument credibility (whether for or against conviction). But it is just a picture. Monitoring the neurological activation of individual brains in response to such conditions as videos of painfully impacted limbs, legal arguments, classic paintings, advertisements, and so on, has reached the point where an alternative point of view is being offered on statistically questionable, “voodoo correlations” in fMRI research.

The debate is whether or not mirror neurons exist in human beings. Even if they do not, mirror neurons in monkeys have completed the work that needs to be completed. Some kind of mirroring system exists. It is highly probable that there is an analogous system, even if more complex and diffuse, in humans that functions in mirroring emotions and behavior and that underlies our relationships in empathic community.

However, what the debate has suggested, entirely independently of the status of mirror neurons, is that human beings are connected biologically in a way, not completely understood, such that we resonate with one another affectively. The debate over whether human beings have mirror neurons in the narrower sense continues. The neuro-hype is dialed down in the year ahead.

  1. Empathy is good for you health and well-being. Empathy is on a short list of stress reductionpractices including meditation (mindfulness), Tai Chi, and Yoga. Receiving empathyin the form of a gracious and generous listening is like getting a spa treatment for the soul.   

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. Note: the list of evidence-based articles and peer-reviewed publications is long, not repeated in this short blog post, and can be found in Chapter Four of my Empathy Lessons .

  1. Online empathy in cyberspace: While nothing can substitute for an in-person conversation, after two people get to know one another, an online conversation is a good option in case of relocation, bad weather, or unpredictable scheduling dynamics. You know that resistant client who just can’t seem to get to his session due to traffic, rain, or other tenuous excuse? The possibility of an online session, which requires a computer and the privacy of a closed door, shows up the resistance for what it is.

Psychotherapy invokes a virtual reality all of its own – even without cyber space. This is especially the case with dynamic psychotherapy that activates forms of transference in which one relates to the therapist “as if” in conversation with a past or future person or reality, the latter not physical present. Indeed, with the exception of being careful not to step in front of a bus while crossing the street on the way to therapy, we are usually over-confident that we know the reality of how our relationships work or what people mean by their communications. This is less the case with certain forms of narrowly focused behavioral therapies, which are nevertheless still more ambiguous than is commonly recognized.

Think about it: Those who complain about the lack of reality in a conversation over Zoom may usefully consider the amount of fiction and fantasy in any psychodynamic conversation, full stop. Never was it truer that meaning – and emotions such as fear – are generated in the mind of the beholder.

(Note: This trend is in part an excerpt from: Lou Agosta’s article “Empathy in Cyberspace: The Genie is Out of the Bottle” in Theory and Practice of Online Therapy: Internet-delivered Interventions for Individuals, Groups, Families, and Organizations edited by Haim Weinberg and Arnon Rolnick. London and New York: Routledge: To order the complete book, click here: Theory and Practice of Online Therapy [https://tinyurl.com/yyyp84zc])

  1. Empathy and law enforcement: My friends, associates, and colleagues on the police assure me that posters branded with the logo of the local police and a pitch for expanded empathy are showing up in police station locker rooms, break rooms, and behind the scenes facilities. At this point in time, these are for the police, not the public.

Street smart police “get it” that empathy is distinct from compassion or “being nice.” Empathy is a method of data gathering about the experience of the other person. The police officer’s emotional radar has to be out about what the would-be suspect or citizen or fellow officer is experiencing if the officer is to avoid making a potentially bad situation worse.

If the would-be suspect is enraged and about to escalate such a scenario requires a distinct response than if the suspect is afraid and literally shaking in his shoes. Empathy provides  valuable and indispensable emotional intelligence about the mental status of the other person. The police are already guided by their common sense, intuition, and gut feeling in approaching other people. Why not provide explicit training in what to do with one’s empathic receptivity, for that is what this “gut feeling” and intuition amount to? Police departments are realizing that practice in empathy lessons can refine and fine tune the intuition and gut feeling so these actually become powerful tools literally in keeping the peace or when necessary minimizing the appropriate use of force.

All this is important and communities will benefit from expanded empathy on the part of the law enforcement. However, there is another reason that indicates this trend has traction. The public does not always hear about the multi-million dollar financial settlements that municipalities are required to pay for wrongful death or excessive use of force, because these agreements come with rigorous confidentiality clauses. Police who lack training turn out to be extraordinarily expensive to the tax payers. In this context, “lack of training” does not mean insufficient time taking target practice. It means the need for practice in putting oneself in the other person’s shoes and considering possibilities for conflict resolution, de-escalation, and community building. In short, empathy is an important part of the gear deployed by law enforcement as the warrior cop, which will still be needed in extreme situations, gives way to community policing. Really, is there any other kind?

  1. Natural empaths get expanded empathy. This continues the trend from last year. Paradoxically, natural empaths suffer from a lack of empathy. Natural empaths are so sensitive to the pain and suffering of the world that they must isolate themselves, cutting themselves off from the emotional life sustaining recognition and support that people require to flourish and be fully human.

The Natural Empath falls into a double bind, and her suffering seems inevitable. She is swamped by too much openness to the suffering of the other person or overcome by guilt at not living up to her own standards of fellow-feeling and ethics.

But the suffering is not inevitable. Such 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 “tune down” her empathic receptivity and “tune up” her empathic understanding and interpretation, while being more flexible about her ethical standards. Here “flexible” does not mean be unethical, but rather allow for the possibility that one needs to work on the balance between one’s own well-being and that of others in helping others.

Now please do not jump to conclusions. That does not mean the Natural Empath should become hard-hearted or unkind. That would definitely not expand empathy. In order to overcome the breakdown of empathic receptivity, what does one actually do in order to expand or contract one’s empathic receptivity?

The empathy lesson for such individuals? Practice methods of “down regulating” one’s empathy. For example, focus on mentalizing, top down empathy, placing oneself in the other person’s shoes, rather than imaginatively evoking the vicarious emotions of the other person’s experiences. Perspective-taking exercises—imaginatively putting oneself in the other’s point of view—expand the participant’s empathy during training sessions. Perspective taking incidentally promotes helping, “pro social” behaviors when it indirectly activates pro-social emotions such as compassion.

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 empathic receptivity in a given situation, transforming empathic distress into a vicarious experience. Do the work of “up regulating” empathic interpretation whereby one imaginatively puts oneself in the other person’s position and considers the experiences thereby inspired vicariously, reducing the “load” on the emotions. This is different than intellectualizing, compartmentalizing, or distinguishing in thought, but perhaps not different by much. The differences are nuanced, but of the essence.

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.

  1. Empathy and psychiatry: The mind engage fixing their own professional house: The psychiatrists with whom I talk advocate a deep and authentic appreciation of the practice of empathy—in order to get the patient to take the medicine. I express agreement—if you are thinking of stepping in front of a bus, don’t! Take the medicine and live to fight another day.

However, this points to the blind spot in psychiatry: A conversation for possibility with another empathic human being also changes one’s neurons and does so in a different but as deep and powerful a way as a psychopharmacological intervention. The mechanism is complex is not fully understood, but neither is the mechanism for lithium salts or antipsychotic medications.

Psychiatrists and many general practitioner MDs are perpetuating a fiction that the drugs they are prescribing are correcting biochemical deficiencies caused by disease, much as (say) a prescription of insulin corrects a biochemical deficiency caused by diabetes (for example see Anne Harrington’s The Mind Fixers, p. 273, which I have found essential in identifying this trend and whose language I paraphrase here). Such rhetoric is badly oversold. No one is saying that the medicines do not help the person tolerate distress, regulate emotions, or self-sooth. Often they do. However, the rhetoric is indefensible and the science is at best a work in progress.

Given the complexity of the scientific challenges, psychiatry need not feel embarrassed. However, neither should it be enthusiastically promoting imminent breakthroughs and revolutions as if it were an adjunct to the popular press or a corporate press release.  

The underlying science is not anywhere near the level the neurohype would have us believe. “You have a chemical imbalance” is a marketing position, not a scientifically established truth. “Schizophrenia is like diabetes and you have to take this antipsychotic drug for the rest of your life” is a rhetorical position, not a scientific fact. This is scientism, not science. This is psychiatry’s troubled search for the biological basis of mental illness. The trend being highlighted here is that, as a profession, psychiatry will focus on medical interventions in the context of culture and community.

  1. The one-minute empathy training is trending: Remove the obstacles to empathy such as cynicism and bullying—and empathy comes forth. Remove the resistances to empathy and empathy naturally and spontaneously expands. Most people are naturally empathic.

Eliminate the obstacles to empathy and a space of acceptance and toleration spontaneously comes froth.

Now do not sufficiently appreciate this: people are born with a deep and natural capacity for empathy, but they are also born needing to learn manners, respect for boundaries, and toilet training. Put the mess in the designated place or the community suffers from diseases. People also need to learn how to read and do arithmetic and communicate in writing. But there is a genuine sense in which learning to conform and follow all the rules does notexpand our empathy or our community. It does not help the cause of expanded empathy that rule-making and the drumbeat of compliance are growing by leaps and bounds.

The work at hand? Remove the blocks to empathy such as dignity violations, devaluing language, gossip, shame, guilt, egocentrism, over-identification, lack of integrity, inauthenticity, hypocrisy, making excuses, finger pointing, jealousy, envy, put downs, being righteous, stress, burnout, compassion fatigue, cynicism, censorship, denial, manipulation, competing to be the biggest victim, insults, injuries to self-esteem, and narcissistic merger—and empathy spontaneously expands, develops, and blossoms. Now that is going to require some work!

Teaching empathy consists in overcoming the obstacles to empathy that people have acquired. When the barriers are overcome, then empathy spontaneously develops, grows, comes forth, and expands. There is no catch, no “gotcha.” That is the one-minute empathy training, pure-and-simple. 

Okay – I have read enough and I want to order the book Empathy Lessons to learn more about expanding my empathy: I want to order the book HERE.

 (c) Lou Agosta, PhD and the Chicago Empathy Project