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Empathy: Capitalist Tool (Part 2): “CEO” now means “Chief Empathy Officer”
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.
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.
[ii] Anonymous Contributors. (nd). Jack Welch. Wikipedia: https://en.wikipedia.org/wiki/Jack_ Welch [checked on June 30, 2017].
[iii] Ibid, Jack Welch, Wikipedia
[iv] Ibid, Jack Welch, Wikipedia
[v] Melvin Urovsky. (1998). Pullman strike, Britannica Online: https://www.britannica.com/event/ Pullman-Strike.
[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
Empathy: Capitalist Tool (Part 1): The Empathy Deficit in Business is Getting Attention
The empathy deficit in business is getting attention
Listen to podcast on Spotify or via Anchor: https://anchor.fm/lou-agosta-phd/episodes/Empathy-Capitalist-Tool-Part-1-The-Empathy-Deficit-in-Business-is-Getting-Attention-e18tlcn
Children and parents get it. Nurses and doctors get it. Teachers and students get it. Couples get it. Consultants and clients get it. Neighbors get it. What about business people? Do they “get it”—that empathy produces results? Practicing empathy is a neglected opportunity in business. The qualities, practices, and behaviors that help a person build a business sometimes work against expanding the person’s empathy.
An executive’s ego, opinion, expertise, and attachment to being right raise the bar on empathizing with others, who may have diverging mind sets. Hard charging entrepreneurs find it hard to let go of their status or set aside the lessons learned as they came up through the ranks. Executives and managers lose touch with the experiences, perceptions, and perspectives of customers, employees, and stake-holders.
The urgent drives out the important. Management effort and time are monopolized responding to competitive pressures, compliance issues, legal challenges, and solving technology problems.[i] For example, according to a report from Businessolver, a human resources and talent consultancy, some 60% of executives believe that their organizations are empathic, whereas 24% of their employees agree.[ii] An empathy deficit?
The stress of operating the business—deadlines, financial issues, staffing crises, software breakdowns, competition, litigation—drive out empathy and a deep appreciation that a commitment to empathy is good for business. The disconnect is substantial between perceptions in the executive suite and in the cubicles of workers and the front line, customer-facing staff.
Ironically, the empathic practices such as the receptive, interpretive, and responsive processes described in detail in this work (as opposed to compassion) are what are most urgently needed in dealing with customer demands, employee crises, negotiations with competitors, vendors, clients, and one’s own budgeting authorities and board, optimally resolving conflicts with reduced cost and impact.
When I ask business leaders what is their budget for empathy training, the response is often a blank stare. Zero. However, when I ask the person what is the budget for expanded teamwork, reduced conflict, enhanced productivity, commitment to organizational goals, taking ownership of outcomes, product and service innovations, then it turns out that budget exists after all. Empathy makes a difference in connecting the dots between business skills and performance. Empathy contributes to results in a powerful way by engaging the staff’s energies and commitments at a fundamental level.
While every business has its own distinct commitments, in many ways, the basic empathy training in business is the same as empathy training in every other context.
The training consists in surfacing and driving out the cynicism, denial, shame, implicit threats, and pressure that many business people experience in their communications. Empathy then spontaneously comes forth and expands the space of possibilities to do business. This does not mean that businesses do not have their own blind spots when it comes to empathy. They do. Therefore, let us take a step back and look at what it is going to take.
An appreciation of the value of empathy to promote breakthrough results often starts in sales. In business, the sales people get it. Developing empathy with customers is good for business.
Even the cynical sales person recognizes that putting oneself in another person’s shoes is a good method of selling them another pair.[iii] The sales person gives the prospect some empathy. Shazam! The customer calls you to close the deal. Wouldn’t it be nice?
Yet the basic idea is straightforward. When the customer appreciates that the sales person is interested in the customer’s requirements, that the sales person is listening, then the customer is likely to open up and candidly share what is stressing him—budget, deadlines, internal politics, market dynamics, or the competition.
When the prospective customer feels that the sales person has understood him, the chance is significantly expanded that he will prefer to purchase the product or service from the empathic representative. Once the customer feels the sales person is listening, the customer will share details about his needs, vulnerabilities, and shortcomings, including those about which he might otherwise be defensive, enabling the sales person to position the product or service as a solution to the perceived problem.
This is not “new news.” In 1964, in the Harvard Business Review—not exactly an obscure, backwater publication—David Mayer and Herbert M. Greenberg called out the two basic qualities that any good sales person must have: empathy and ego drive. These authors define “empathy” as the central ability to feel as other people feel in the context of selling them a product or service.
In Mayer and Greenberg’s article, the sales staff were trained to interrupt themselves when they found that they were reacting defensively to customer complaints, whether legitimate or not, whether solvable or not. Stop—hit the pause button before responding. Instead of reacting to the complaint, the sales person was trained to “get” the complaint and to communicate back to the customer that he “got it,” namely, that the customer was upset (or whatever the customer was self-expressed about).
The sales person was trained to acknowledge that a breakdown had occurred. Key term: breakdown. The sales person was trained to acknowledge the complaint by calling it out: “This is a break down!” Even if the customer is inaccurate or wrong in his complaint about some detail, the customer is always—the customer.
By definition, the breakdown in the product or service occurs against the expectation of customer satisfaction. The relationship between the buyer and seller is itself in breakdown against the expectation of satisfaction. This does not rule out the possibility that additional training is needed on the part of the customer about product features or the service level agreement; but such training is substantially different from a defensive reaction.
The next step is repairing, fixing, or at least managing the cause of the complaint: the respondent then solicits additional feedback and details as to the complaint, i.e., what went wrong. The empathic response includes what one is going to do about the breakdown and by when.
The committed listening, that is, empathy, creates a clearing for communication, improving the sales process, and restoring authenticity to the relationship when integrity has gone missing. While there are no guarantees, customers treated in such a way tend to stick. Repeat business, maximizing revenue over the lifetime of the relationship, is one of the outcomes. [iv]
The empathic leader meets “economic man”
Development Dimensions, Intl., (DDI) identifies empathy as one of the critical success factors in executive leadership. One of the leading talent development corporations in the market, DDI’s report on High Resolution Leadership identifies empathy as an emotional quotient (EQ) “anchor skill.”
Empathy provides the foundation for interpersonal leadership skills such as developing subordinates, building the consensus for action, encouraging engagement, supporting self-esteem, and taking responsibility.[v]
In the DDI study, listening and responding with empathy were demonstrated by 40% of executives profiled (as opposed to 71% whodemonstrated taking responsibility or 54% who demonstrated building agreement on actions to take).
The conclusion is that, as regards empathy, the majority of leaders have room for expanding their performance. The good news is that, using interventions designed to expand empathy, the empathy skills needed to drive business results are within reach. [vi]
Thus, the empathy deficit in business is getting attention. Empathy is moving to the foreground. The role and contribution of empathy to business results is penetrating the awareness of leaders, managers, staff, and stake-holders.
Closely related to the challenge of closing the empathy deficit in business is the challenge that “economic man” is significantly different than man as such. Let’s define our terms.
The person who conducts transactions in the market is defined in business school as economic man—homo economicus. The latter is significantly different than man, the human being as such. The person (man) in the economic theory is rational, selfish, and her or his tastes do not change.
Business practices assume the organization is engaging with customers, employees, stake-holders, and leaders who fit the model of economic man. Human beings, on the other hand, do not. Most people in business do not know anyone who fits the description of economic man. Why then are we so busy trying to do business with him when he does not even exist?
Unlike the person described in economics in business schools, humans are limited in their reasonableness. Humans are diverse and inconsistent in their preferences. Humans are even limited in their selfishness, being generous and compassionate in unpredictable ways.
The issue? Nobel Prize winning economist Gary Becker’s rational choice theory (preference theory) in economics has been extended to many other aspects of life. Becker’s rational choice theory has been extended to areas as diverse as marriage, crime, and discrimination.
Generalizations from rational choice theory to the social sciences at large have been a growth industry in the social sciences. From the rich mixture of inconsistencies and contradictions that most people really are in life, the human being was translated into a function of rational, self-interested, and allegedly consistent preferences. The human as such has been simplified and redescribed as a rational, calculating engine of human behavior.[vii]
People are supposed to be consistent in their preferences and tastes. People are supposed to be logical and consistently obey the rules. But finding counter-examples is easy.
For example, if a person prefers coffee to hot chocolate and the person prefers hot chocolate to tea, then, according to this logic, the person is supposed to prefer coffee to tea. [Think: coffee > hot chocolate > tea; therefore, coffee > tea, according to the transitive rule, in which “>” means “prefers.”] But, no, it doesn’t work that way. Given all these personal preferences as indicated, the person still chooses tea instead of coffee. The person just prefers tea to coffee. The individual is from London!
Nothing inherently illogical exists in preferring coffee to hot chocolate and tea to coffee while also preferring hot chocolate to tea. Nothing unless one insists on making a dynamic network into a transitive sequence. So much for rational choice theory.
The lesson? Empathy as well as logic are required to understand decision making. Without allowing for the possibility of empathy, economics produces some strange results. People are not natural born statisticians, logicians, or gamblers, though the discipline of economics sometimes seems to assume so.
Still, testing a person’s decisions and preferences using probabilities, bets, and lotteries is an engaging exercise, and nothing is wrong in doing so. However, unless one also adds empathy to the mixture of economics and logic one misses something essential—the person!
Now, I apologize in advance to the reader for the technical terms, but in economics the chance of winning a bet is expressed as an “expected utility.” “Expected utility” is technical talk for “satisfaction” or “happiness.” (But nothing more than arithmetic is needed to get this. )
For example, in economics the expected utility of a 10% chance of winning a million dollars is $100K [.10 x 1,000,000 = 100,000] [note: K = 1,000]. If Jack and Jill both end up with a million dollars, they should enjoy the same expected utility, no? Remember, Jack and Jill are supposed to be rational, selfish, and consistent in their preferences. Now consider a counter-example:
Today Jack and Jill each have a million dollars.
Yesterday Jack had zero and Jill had two million dollars.
Are they equally happy? (Do they have the same utility?)
You do not need an advanced degree to know that today Jack is very happy and Jill is in despair. Yesterday Jack had zero; now he has a million dollars. Hurrah! Yesterday Jill had two million dollars; now she has only one million. Ouch!
We must be able to put our ourselves in the shoes of Jack and Jill and get a sense of their expectations. Sounds familiar?
These expectations, in turn, constrain their experience of satisfaction (i.e., happiness). To grasp the outcome in terms of their individual experiences, we need an empathic anchor or reference point in their expectations from which they begin. Empathy gives us access to an anchor point in their respective experiences.
Our empathy shows that outcomes are linked to feelings about the changes of one’s wealth rather than to states of wealth. The experience of value depends on the history of one’s wealth, not only the current state of it.
Yet another bold empathy lesson: People are strongly influenced by hope and fear. Empathy indicates that people attach values to gains and losses, and these are weighted differently than logical probabilities in decision making. This is not just saying that people are irrational, though that may be true enough at times, too. This says that people (and their behavior) frequently do not conform to the pattern of rationality, selfishness, and consistency in preferences.
Still, the matter is not hopeless for those committed to pattern matching in economics. People are frequently surprising, but sometimes in predictable ways. People are sometimes inconsistent, but one can sometimes predict those inconsistencies if one learns one’s empathy lessons.[viii] For example:
(1) People are risk averse due to fear of disappointment and regret. The empathy lesson is that people try to avoid risks even in situations where taking a risk is a good bet. “A good bet” is determined according to the probability calculation.
Consider: if a person had a 90% probability of winning a million dollars, he ought to accept $900K as a “sure thing” settlement, which settlement is logically equivalent to a 90% probability of winning the million dollars [.9 x 1,000K = 900K]. The 10% probability of not winning is an unlikely outcome, but still possible. The “unlikely outcome” often determines the result.
For example, law suits in cases of accidents and contract disputes produce settlements in trial law indicating that people will “settle for” $800K or even $750K for the possibility of knowing the outcome with certainty. For most people that is still a lot of money, and the possibility of having to live with the regret of missing the pay-off due to an unlikely outcome gets most people out of their comfort zone. They decide to settle.
Empathic receptivity to the possibility of disappointment and regret may usefully “override” the rational, self-interested, and consistent preferences that the purely economic person brings to the negotiations.
(2) People are risk seeking in the hope of getting an even larger gain instead of accepting a modest settlement.
This is why people bet on the state lottery where the chance of winning is vanishingly small. Such a bet is illogical, but common. We need expanded empathy to get a clue what is going on here.
The empathy lesson indicates that people are not buying a chance to win a big pot of money. Rather people are buying a chance to dream of the possibility of winning the big jackpot. “We are such stuff as dreams are made of,” said Shakespeare. The value is in the dreaming, that is, precisely in the possibility of the big jackpot, not the jackpot itself. That such a dream would more likely be the dream of a poor person rather than an affluent one is a further problem that invites attention.
If one looked rationally at the odds, one would not buy the ticket. No way. Clearly lotteries are popular, especially with the poor and “have nots.” The possibility of escaping from poverty is being manipulated in a cynical way by the establishment, and we citizens have all become “addicted” to the revenue stream.
The lottery budget and effort would be better devoted to job training and instruction in basic financial management, except now lotteries have become a source of revenue for local government and education. This is a breakdown in empathic understanding, which gives us our possibilities. It is hard not to become a tad cynical in considering that the poor are paying for education through lottery revenue, though they are often unprepared to benefit from or hindered from accessing the educational opportunity.
(3) People are risk seeking in the hope of avoiding a loss in situations in which simply stopping a project altogether would enable cutting their losses (rather than incurring additional likely losses). Defeat is difficult to accept. The empathy lesson is that people are attached to an ideal, in this case a losing cause, for reasons extending from perseverance, egoism, greed, risk aversion, fear of the unknown, all the way to idealism, romance, blind hope, and just plain stubbornness.
People (and businesses) facing a bad outcome manage to turn a survivable (but painful) failure into a complete meltdown. Desperate gambles often make a bad situation worse in exchange for a small hope of avoiding the loss at all. Businesses, individuals, and even countries, continue to expend resources long after they should blow the bugle, lower the flag, and leave, implementing an orderly retreat. Instead people (and organizations) persist in a lost cause until a rout becomes inevitable.
Business accounting teaches the basic idea of a “sunk cost.” Suppose Octopus, Inc., (OI) is building a new software system for $100 million dollars. OI has already spent $150 million. The project is over-budget. It is estimated to take another $55 million to complete the job. Suppose further that evidence of a new, breakthrough technology really exists. It would enable OI to develop the system from scratch for $25 million. What should OI do? The money already spent is a “sunk cost.” It should not influence the decision. Given the evidence that the new technology really works, the OI project leader should throw away the over-budget system and build the new one from scratch, spending $25 million and saving $30 million against the projected completion cost of the project. However, that is not what most project leaders would do.
Due to a sense of ownership of the over-budget project and a fear of the unknown in engaging the new technology, many project leaders double down on the investment in a losing proposition. In a breakdown of empathic interpretation, they continue to project their hopes and fears onto the old technology and, as the saying goes, throw good money after bad.
(4) People are risk averse due to a fear of a large loss and may rationally and usefully bet on a small chance of (avoiding) a large loss. This is why people buy insurance. The empathy lesson is that people are not merely buying protection against an unlikely disaster; they are buying peace of mind, the ability to get a good night’s sleep. If the negative event would have catastrophic consequences, creating a risk pool, in which everyone participates, spreading the risk in a manageable way, makes compelling sense. Note that certain risks such as war and civil insurrection (or a giant asteroid hitting the earth) are uninsurable. Insurance is a calculation, not a gamble against undefined odds. In general, the insurable risk must relate to individuals or subgroups and the occurrence of the risk should not destroy the infrastructure of the entire community, which needs to be intact to cover the insured risk.
Insurance was a brilliant business innovation that emerged at about the time of the European Renaissance as traders in the Netherlands—those frugal Dutch—were sending valuable but fragile ships to fetch precious cargo in far away lands. The risks and rewards were great. How to even out the odds? Insurance was born.
In our own time, one can see the irrationality, the unempathic response, and gaming of the system by special interests in health insurance in the USA where attempts were made to exclude the sickest people from the insurance pool through penalties for preexisting illnesses, combined with charging monopoly rents to the healthiest participants.
Insurance is often a “good bet” when an outcome that is highly unlikely but catastrophic can be managed by everyone (or a large group) incurring a small cost to spread the risk. But how to get everyone at risk into the pool? When told that people have no health insurance, some politicians are supposed to have said: “Let them pay cash!” In another context, in one the most spectacular breakdowns in empathic responsiveness in modern European political history, the French Queen, Marie Antoinette, was told that the people had no bread, and she is supposed to have said: “Let them eat cake!” Same idea?
Saying that the purpose of business is to make money is like saying the purpose of life is to breathe. Keep breathing—and make money—by all means. But the purpose of life is to find satisfaction in one’s work, raise a family, write the great American novel (it’s good work if you can get it!), experience one’s efforts as contributing to the community and making a difference.
Likewise with business. Business is about delivering human value and satisfying human demands and goals, whether nutrition, housing, transportation, communication, waste disposal, health, risk management, education, entertainment, and so on. Even luxury and conspicuous consumption are human values, which show up as market demands.
In conclusion, business people “get it”—empathy is good for business. Profit is a result of business strategy, implementation, and operations, not “the why” that motivates commercial enterprise. And if profit shows up that way (as the “the why”), then you can be sure that, with the possible exception of index derivative hedging, it is a caricature of business and a limiting factor. Business prospers or fails based on its value chain and commitment to delivering value for clients and consumers. However, as noted, some of the things that make people good at business make people relatively poor empathizers.
Business leaders lose contact with what clients and consumers are experiencing as the leaders get entangled in solving legal issues, reacting to the competition, or implementing the technologies required to sustain operations. Yet empathy is never needed more than when it seems there is no time or place for it. This is a challenge to be engaged and overcome.
What to do about it? Practice expanded empathy. Empathy is on the critical path to serving customers, segmenting markets, positioning products (and substitutes), psyching out the competition—not exactly empathy but close enough?—building teams and being a leader who actually has followers. Empathy makes the difference for contributors to the enterprise at all levels between banging on a rock with a hammer and building a cathedral. The motions are the same. When the application of empathy exposes and strengthens the foundation of community, then expanding empathy becomes synonymous with expanding the business. Building customer communities, building stakeholder communities, building teams that work, are the basis for product innovation, brand loyalty, employee commitment, satisfied service level agreements, and sustained or growing market share. Can revenue be far behind? Sometimes leaders don’t need more data, leaders need expanded empathy, though ultimately both are on the path to satisfied buyers, employees, and stakeholders. If the product or service is wrappered in empathy, has an empathic component as part of the service level agreement, gets traction in the market, and beats the competition’s less empathic offering, then we have the ultimate validation of empathy. We do not just have empathy. We have empathy Capitalist Tool!
Notes
[i] Katja Battarbee, Jane Fulton Suri, and Suzanne Gibbs Howard. (2012). Empathy on the edge: Scaling and sustaining a human-centered approach in the evolving practice of design, IDEO:
http://liphtml5.com/gqbv/uknt/basic [checked on 03/31/2017].
[ii] William Gentry. (2016). Rewards multiply with workplace empathy, Businessolver: http:// http://www.washingtonpost.com/sf/brand-connect/businessolver/rewards-multiply-with-workplace-empathy/ [checked on 03/31/2017].
[iii] Roman Krznaric. (2014). Empathy: Why It Matters, and How to Get It. New York: Perigree Book (Penguin): 120.
[iv] C.W. Von Bergen, Jr. and Robert E. Shealy. (1982). How’s your empathy? Training and Development Journal, November 1982: 22–28: http://homepages.se.edu/cvonbergen/files/2012/11/Hows-Your-Empathy.pdf [checked on 03/31/2017].
[v] Research Staff. (2016). High Resolution Leadership, Data Dimensions, Intl.: http://insight. ddiworld.com/High-Resolution-Leadership [checked on 03/31/2017].
[vi] William Gentry, Todd J. Weber, Golnaz Sadri. (2007). Empathy in the workplace: A tool for effective leadership, http://www.ccl.org/wp-content/uploads/2015/04/EmpathyInTheWorkplace.pdf [checked on 03/31/2017].
[vii] Bernard E. Harcourt. (2015). Exposed: Desire and Disobedience in the Digital Age. Cambridge, MA: Harvard University Press.
[viii] Daniel Kahneman. (2011). Thinking, Fast and Slow. New York: Farrar, Straus, and Giroux.
(c) Lou Agosta, PhD and the Chicago Empathy Project
Empathy as presence – online and in shared physical space
Review: Gillian Isaacs Russell, (2015), Screen Relations: The Limits of Computer-Mediated Psychoanalysis and Psychotherapy. London: Karnac Books: 206 pp.
Granted in-person physical meetings are impossible when the health risks become prohibitive, that is no longer the case (Q3 2021), at least temporarily. Therefore, the debate resumes and continues about the trade-offs, advantages and disadvantages, of online telecommunication (“Zoom”) mediated therapy sessions versus physical in-person work.[1]
Gillian Isaacs Russell’s book in a powerful and important counterforce to trending technological optimism that online therapy is the wave of the present and of the future. This optimism compels those of us who are digital immigrants to align with digital natives in privileging screen relations over physical presence in the same space in engaging in psychoanalysis and psychotherapy. By definition, “digital immigrants” were educated prior to the explosion of the Internet (and world wide web on) or about the year 1999 and “digital natives” came up with “online everything” such as pouches for their smart phones in their parents’ baby strollers.
The cyber rush to judgment is slowed if not stopped in this hard-hitting critique of online screen relations. Isaacs Russell wisely asserts skepticism that meeting online (even in a pandemic) and meeting physically in person are “the same.” One may eventually go ahead with online therapy in many situations (especially in a pandemic), but if you are hearing “they are both the same” that is reason for a good healthy skepticism that the purveyor of the online approach is being straight with you. One also needs to be skeptical as online therapy starts out being “better than nothing” only quickly to slide in the direction of “better than anything.” As usual, the devil – and the transference – is in the details, and Isaacs Russell provides insight in abundance to the complex issues.
Speaking personally, in my own work on empathy, published in 2015, the same year as Isaacs Russell’s book, my Preface concludes with the ontological definition of empathy as “being in the presence of another human being without anything else added” – anything else such as judgment, evaluation, memory, desire, hostility, and the many factors that make us unavailable to be in relationship (Agosta 2015; see also 2010). Though Isaacs Russell uses the word “empathy” in a specific psychological sense, I would argue that her work on “presence” is consistent with and contributes to an enlarged sense of empathic relatedness that builds community.
Isaacs Russell has interview psychoanalysts, clients (clients), over several years and reports in a semi-ethnographical style on the trade-offs between online mediated relations and those which occur in the same physical space, such as a therapist’s consulting room. Her arguments and narratives are nuanced, charitable, and multi-dimensional. The reader learns much about the process of dynamic therapy regardless of the framework.
What she does not say, but might usefully have called out, is that the imperative is to keep the treatment conversation going, whether online or physically present in person. When someone I am meeting with in-person asks for an online session, after controlling for factors such as illness of a child at home or authentic emergencies, then my countertransference may usefully consider the client’s resistance to something (= x) is showing up. In contrast, when an online client asks to come into the office, one may usefully acknowledge that the individual is deepening his commitment to the work. In neither case is this the truth with a capital “T,” but a further tool and distinction for interpretation and possibility in the treatment process.
Isaacs Russell makes the point (and I hasten to add) that no necessary correlation exists between the (digital) generation divide and enthusiasm (or lack thereof) for online screen relations of baby boomers versus millennial or gen-Xers. Some digital immigrants are enthusiastic about online therapy, whether for authentic professional reasons, including economic ones, or to prove how “with it” they are, and growing numbers of digital natives are becoming increasingly skeptical about the authenticity of online relations, craving physical presence without necessarily being able to articulate what is missing.
Isaacs Russell provides an informative and wide-ranging briefing on developments in baby watching (child development research). Child development is a “hands on” process of physically relating to another emerging human being. Her point (among many) is that we humans are so fundamentally embodied that in some deep sense we are out of our element in reducing the three dimensional, heat generating, smell-broadcasting mammalian body to a cold two-dimensional video image. Though she does not do so, Isaacs Russell might usefully have quoted Wittgenstein: The human body is the best picture of the soul (1950: 178e (PPF iv: 25)). As the celebrity neuroscientist A. Damasio notes: [We need] “the mind fully embodied not merely embrained.” What then becomes of the relatedness when the body becomes a “head shot” from the shoulders up on a screen?
The answer is to be found in the dynamics of presence. Key term: presence. Physical presence becomes tele-presence and the debate is about what is lost and (perhaps) what is gained in going online. The overall assessment of Isaacs Russell is that, not withstanding convenience and the abolition of distance, more is lost therapeutically than gained.
Although Isaacs Russell does not cite Wittgenstein, Heidegger, Husserl, and Merleau-Ponty loom large in her account of the elements of presence. Much of what Isaacs Russell says can be redescribed as a phenomenology of online presence, including the things that are missing such as smell, the ability to physically touch, aspects of depth perception, and the privileging of “on off” moments over against gradual analogical transitions. The above-cited philosophers were, of course, writing when the emerging, innovative, disruptive technology was the telephone, and Heidegger himself went “off the grid” physically (and morally!) with his semi-peasant hut in the Black Forest near Freiburg, Germany. But even though they never heard of a mirror neuron, the distinctions these thinkers lay down about relatedness are fundamental for work in communications and human understanding.
Isaacs Russell gives the reader a generous tutorial in breakthrough developments in neuroscience, including the discovery or mirror neurons in Macaque monkeys and a neurologically-based mirroring systems in humans, which account for key aspects of empathy, intersubjectivity, and human social-psychological relatedness.
Since this is not a softball review, I must inquire, following detailed descriptions of embodied cognition, the primacy of movement in empathic relatedness, faces as emotional hot spots (which nevertheless incorporate full-bodied clues as to the exact emotion), kinesthetic and proprioceptive feedback: do we need a psychoanalysis or rather do we need an aerobics class (okay, at least a class in Tai Chi, moving meditation)? The point is that both participants may indeed “forget” about the computer-mediated relation, but the unconscious does not. The (unconscious) transference is also to the technology and needs to be engaged, interpreted as such. Isaacs Russell provides the distinctions to do so, which is what makes her contribution so valuable, even if one disagrees with her ultimate skepticism that online is the wave of the future.
Amid many useful distinction and nuances, as noted above, the key-differentiating variable for Isaacs Russell is presence. She connects this closely to D. W. Winnicott’s seminal work on enabling the client to recover the ability to “go on being” in integrity and individuality, even in the presence of another person. The model for this therapeutic process is the young child’s breakthrough in individuality as the child is able to be alone (e.g., playing) in the presence of the mother (or care-taker).
This process of becoming an individual being gets operationalized and tested when the client tries to destroy the therapist and the therapist [demonstrates that s/he] survives. Here “destroy” is a technical term, though it does indeed invoke hatred and the possibility of aggression. The paradigm case is that the client expresses hostility – even hatred – towards the therapist and the therapist does not retaliate. The therapist “takes it,” metabolizes the aggression and responds appropriately setting an empathic boundary in the relationship. This advances the treatment, expanding the integrity, autonomy, and individuality [mostly] of the client.
According to Isaacs Russell, this is the key moment – the differentiator: “In ‘screen relations’, the client can never really test the analyst’s capacity to survive” (p. 37).
Why not? Isaacs Russell quotes an astute client (in so many words) that without being in the same shared space the potential for the client or therapist “to kiss or kick” the other is missing. The potential for physical desire or aggression has been short circuited. Since the treatment must engage with these variables, the treatment is stymied and deprived of essential enriching possibilities of transformation.
Isaacs Russell is adamant that the ability of the therapist to survive, in Winnicott’s sense, cannot be test in the online context. If it could be significantly tested, then much of what she writes about the inadequacies of online presence would be invalidated or at least significantly reduced in scope. As noted, Isaacs Russell makes much of the potential to “kiss or kick” the other person in the same physical space; and it is true that such acting out rarely occurs but what is needed is the potential for its occurring.
However, what has been overlooked is such acting out bodily is not the only way of testing the separation and survival of the therapist. Many examples exist in which the client tests the limits by means of a speech act – seductive or aggressive language. Speech is physical and would not occur with the sound waves impacting the biology of the ear. This is not merely a technical point. Tone of voice, rhythm, and timing are physically available.
The distinction “speech act” is one that is critical path in any discussion of the talking cure, even if the latter is understood in an enlarged sense to be the encounter of two embodied (not merely “embrained”) talkers and listeners. Speech act theory includes pragmatics that allow for the illocutionary and perlocutionary force of speech. Speech does not merely describe things – it performs things, building connections and relations. People get other people to do things – change the physical environment – by speaking to them: close the door! Pick up the kids at soccer! Persons invested with certain kinds of conventional authority, powerfully change relationships and other aspects of the human world. For example: “I now pronounce you man and wife” spoken by the officiating authority at the wedding. This is a new reality – in so many ways. The empathic response of the therapist, spoken to the struggling client, is another such example.
Language is powerful, and we humans both wound and heal through our words. Heidegger, who is usefully quoted by Isaacs Russell as inspiring the work of Merleau-Ponty regarding physical spatial dynamics also noted, “Language is the house of being.” That is, presence – physical, mental, poetical, historical – emerge in the conversation that we have individually and in community in language.
Recall that Winnicott’s point is that when the client acts out – in this case verbally – the therapist demonstrates his survival skill by not retaliating. Thus, s/he remains in integrity as a “good enough” partner in empathic relatedness and becomes independent. This likewise rebounds to the expanding integrity and independence of the client.
If the therapist does retaliate – say by moralizing or withdrawing or blaming or becoming aggressive or seductive – then the possibility of treatment in the relationship is short-circuited. Absent significant repair, the relationship ends, even if the conversation continues in an impasse for awhile longer.
Speaking personally, and omitting confidential details, I recall an instance online where, being clumsy with a relatively new online client, who was vulnerable in a way that I did not appreciate, I triggered a challenge to my survival. I triggered a combination of panic, retraumatizing flashback, and panic, in the client that resulted in an extended and seemingly automatic combination of verbal abuse. It threatened me professionally and the safety of the client such that I seriously thought of sending emergency services to the client’s address. The screen is always the screen, in this case, but the screen was no protection against the impact of the hate. It is a further question whether the same thing might have happened if my clumsiness had occurred in person. Perhaps the client would have kept quiet and never returned. We will never know.
So while the client might not effectively have been able to throw a pencil at me (to use Isaacs Russell’s example), the individual would have been able to inflict self-harm in a way that would do more damage to me than a kick in the shins (another Isaacs Russell example). Never underestimate the ability of clients to innovate in acting out around the constraints of an apparently firm therapeutic framework.
The good news is that, without making any commitments I couldn’t keep, by a combination of soothing statements, placating statements, self-depreciating humor, apologetic words, and deescalating inquires and suggestions, I kept my wits about me, and was able to restore the integrity of the therapeutic process. S/he agreed to continue the conversation. I survived and so did the relationship. It actually was a breakthrough, and, without everything being wonderful, the client demonstrated capabilities that had not previously had going forward.
Thus, the counter-example: Survival was tested online, not by physically throwing a pencil, but in reciprocal speech acts and the enactment of presence in speech, a physical media not to be underestimated. One learns that the environment is safe when safety breaks down. To Isaacs Russell’s point, the potential for non-survival also includes non-survival as an actual enactment and outcome – and neither online nor physical presence has a privilege in that regard.
In a real world emergency – a credible threat of self-harm – there is a difference between sending emergency services to the client location and summoning them to one’s own office. But perhaps not that much. The point about survival, safety, and containment (different but overlapping issues) and their respective breakdowns is the same. Many distinctions exist between an online and physical encounter, but the risk of survival or non-survival occurs in each context.
One may argue back that the risk of a meltdown is less extreme in the warm and cozy confines of one’s own office, but maybe you never met a borderline client like this particular one or a client as suspicious or deeply disturbed. If the client takes out a box knife on camera and starts to carve up her or his inner thigh (or threatens to do so), one may fervently wish that s/he kicked one in the shins instead.
Thus, in answer to the potential for “kicking or kissing,” the answer is direct: Oh, yes the client can – can indeed test the capacity to survive and do so online. The example “kiss or kick” is not a bad example, but many counter-examples exist that provide useful evidence to the contrary as cited above.
Positively expressed, plenty of evidence is available that the analyst’s survival can indeed be tested in an online session and s/he may survive or not. Ultimately even “kiss and kick” can be enacted as verbal abuse on line, perpetrating boundary violations with hostility or seduction that can be grave and survival threatening, either in imagination or reality, including the survival of the therapist as a professional and the therapy itself.
To give the devil his (or her) due, it is true that there are some cases that are decidedly unsuited for an online engagement. Marion Milner engaged in a celebrated analysis of a deeply disturbed and regressed client, in which the client was silent for long periods of time.[2] The client finally was able to recover significant aspects of her humanity in producing hundreds of drawings and sketches that expressed a therapeutic process of pre-verbal recovery. It is true that, though these were visual artifacts, and presumably might have been communicated remotely, the client herself was already so “remote” from reality that another layer of virtuality was not going to work (nor was it possible mid-20th century).
Heinz Kohut has a celebrated example that he presented in an lecture made a few days before his death. Kohut was working with a deeply regressed and suicidal client (client) in years gone by. In a desperate moment, Kohut offered to let the client, lying on the couch behind which he was sitting in his customary straight-backed wooden chair, hold two of the fingers of his hand. The point of this potentially life saving (and boundary testing) gesture was Kohut’s association to the client’s desperate grasp with her hand being like that of a toothless infant sucking on a nipple. An empty nipple or a life giving one? Powerful stuff, which of course, would never be possible online. Far be it for me to be the voice of reality, nevertheless, these two cases of Milner and Kohut are outliers, albeit deeply moving one, that are completely consistent with the sensitive and dynamically informed application of online analysis and dynamic therapy.[3]
Though the uses of extended moments of online silence should not be underestimated or dismissed, Milner’s and Kohut’s cases were ones that privileged physical presence. It in no way refutes the power or potential of online engagement. What are missing are criteria for telling the difference. No easy answers here but the rule of thumb is something like: do whatever is going to further the treatment in the proper professional sense of the words. What is going to sustain and advance the conversation for possibility in the face of the client’s stuckness? Do that. Winnicott has been mentioned frequently, and rightly so. He spoke of the “good enough” mother. Here we have the “good enough” therapeutic framework including the online one.
Another part of the narrative that was particularly engaging was Isaacs Russell’s discussion of ongoing online psychoanalytic training with the colleagues in China. There are few psychoanalysts in China, so in addition to significant culture and language challenges, such remote work would not be possible without online analytic therapy sessions and supervision. The nearly unanimous consensus is this is valuable work worth doing. The equally unanimous consensus, about which one may usefully be skeptical, is that this work is “functionally equivalent” or in other ways “just the same as” work done physically in person.
The author provides examples, whether from the Chinese colleagues or other contexts is not clear, where neutral observers are asked to evaluate transcripts of sessions where the online versus physical feature and descriptive details have been masked. The result? They can’t tell them apart. What more do we need to say?
Apparently much more. With dynamic psychotherapy and related forms of talk therapy if you can tell the difference between an online and an in person meeting (other than comments about traffic or Internet connections), then you are probably doing it wrong or there is some breakdown that interferes with the process (in either case). Abstinence is easier online – no hugs. But if we are talking boundary violations, maybe some people – exhibitionists? – are tempted to take off their clothes on camera. (This has not happened to me – yet.) Anonymity – just as one’s office has clues as to one’s personal life, so too does the background on camera. Neutrality – being on camera suddenly causes one to adopt a point of view on social media or politics or nutrition or economics or education? Perhaps but I am not seeing it.
However, what Isaacs Russell does not discuss is the “other” transcript – the unwritten one, which is only available as a thought-experiment. There is another transcript different than the verbatim account of what was said or even what a web cam could record. It is a transcript that is just as important as the recoding of the conversation, and why verbatim recordings of the conversation are less useful than one might wish. Both participants may “forget” that the session is being recorded, but the unconscious does not. There is the transcript of what the people are thinking and experiencing, but remains unexpressed or expressed indirectly. Such an aspect of the counter-transference or thought transcript is harder to access and includes the therapist’s counter-transference.
One thing is fundamental: When the context of the encounter between people is an empathic one, then both an in-person encounter in the same physical space and an online encounter via a video session are ways of implementing, applying, and bringing forth empathy.
The online environment and the imaginary thought transcript present new forms of client resistance and therapist counter-transference, and it is these that now are the main target of the discussion of this essay.
Moving therapy to online opens up a new world of symptomatic acts, parapraxes, “Freudian” slips, and acting out.
I had one online client who stands up in the middle of a session to check on what this individual had cooking in the oven, carrying her camera-enabled device with her. Was I amazed? Indeed.
I acknowledged to the client that clients sometimes have mixed feelings about their therapists, and nothing wrong about that as such. Yet I was wondering did she believe I was perhaps half-baked? Key term: half-baked. Further discussion occurred of whether this individual was expressing her unconscious hostility towards me – while, of course, also preparing a baked dish.
The breakdown in empathy may be a thoughtless remark by the therapist, a mix up in the schedule, or a failure of the computer network. The empathy – and transmuting internalization working through it – LIVEs in restoring the wholeness and integrity of the relatedness. Empathy lives as spontaneous relatedness, a form of transference and vice versa. This is not limited to psychoanalysis versus psychodynamically informed psychotherapy. This is not limited to online versus physical therapy.
Other than candidates for psychoanalytic training, few people are calling up practitioners are saying: “I want the most arduous, rigorous, time-consuming, expensive treatment known – I want a psychoanalysis!” I tend to agree with Isaacs Russell that the possibilities for doing full-blown remote psychoanalysis are – how shall I put it delicately? – remote, but not necessarily due to any features of the online environment.
After all the dynamics and debates are complete, Isaacs Russell ends her book with a masterpiece of studied ambiguity. She gives an account of a conversation in an online session with a client in London, UK. Isaacs Russell has relocated to Boulder, CO, USA. Having worked together in physical presence, the client misses her and Isaacs Russell misses the client – yet the therapeutic conversation continues. One cannot help but agree with the sentiment – there is something missing – and yet the conversation continues. Thus, we roundly critique cyber therapy – and go off to our online sessions.
[1] Acknowledgement: This reviewer first learned of Gillian Isaacs Russell’s penetrating and incisive engagement with all matters relating to online psychoanalysis and psychotherapy from my friend and colleague Arnon Rolnick in Q2 2021 as the 2020 covid pandemic was waning, at least temporarily. Thus, I am catching up on my reading.
[2] Marion Milner, (1969), The Hands of the Living God: An Account of a Psycho-analysis. London: Routledge, 2010.
[3] Charles Strozier, (2001), Heinz Kohut: The Making of a Psychoanalyst, “Gentle into that Good Night,” New York: Farrar, Straus, and Giroux: 376–377.
References
Lou Agosta, (2010), Empathy in the Context of Philosophy. London: Palgrave Macmillan.
Lou Agosta, (2015), A Rumor of Empathy: Resistance, Narrative, Recovery in Psychoanalysis and Psychotherapy. London: Routledge.
Reclaiming Empathy in Online Therapy: An Imaginary Conversation with Sherry Turkle
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 1: Organizational Resistance to Empathy)
You don’t need an expert to practice empathy
Every parent, teacher, doctor, social worker, sales person, person with customers, first responder, consultant, neighbor, or taxi driver already knows a lot about empathy. They would not be successful, much less survive, if they did not practice empathy. You may need a license to be a barber and cut hair. However, outside totalitarian state, no one can require that you have a license to do what comes spontaneously to the vast majority of human beings—be empathic. However, an expert can be helpful in clarifying distinctions, providing tips and techniques, and modeling the empathy you want to get or apply and expand.
Parents are naturally empathic towards their children; teachers, towards their students; medical doctors, towards their patients; business people, towards their customers, consultants towards their clients, and so on. Even if a person is clumsy and does not get empathy quite right, people can’t stop doing it. Yes, that’s right—people can’t stop being empathic; but then fear stops them—fear of experiencing vicariously another person’s pain, struggle, conflict, or suffering—and a breakdown occurs in their empathy. There must be something wrong here! Blame starts flying around. They blame themselves. They blame the other person. They blame empathy.
Even if doctors are trained to “tune down” their spontaneous empathy until it becomes “detached concern”—and good reasons exist for doing that at times—empathy naturally breaks through, and they often relate authentically to their patients as one human being to another in spite of themselves.[i]
The really useful thing is that in learning to contract one’s empathy, one is also learning expand it, because one is learning to regulate and manage empathy. Contracting one’s empathy also means being able to expand it. “Dialing down” empathy also means being able to “dial up” empathy.
“Dialing down” empathy does not mean “stop listening,” “be unkind,” “blame,” “make wrong,” “reject,” “be hostile,” “use devaluing speech,” or “feign thoughtlessness.” Such a response would be absurd.
There is a sense in which a feeling may be socially appropriate or inappropriate—for example to laugh at a funeral when nothing is funny—feelings are valid in themselves in that they always are what they are.
A feeling may be an inarticulate judgment—fear being the judgment that one should run from danger—especially if a mountain lion is coming around the bend. The fear is an absolute given in the moment.
One may wish that one felt differently than one does in fact feel in the moment; but that one feels a certain way is an absolute given.
The best way to turn fear into an out-an-out panic attack is to say to oneself: “This (fear) should not be!” But of course it is, so that means what? One has lost control. Panic!
The recommendation? Accepting the feelings as what’s so does not make an unpleasant feeling any easier to bear, but it takes away its power, drains the upset out of it, and gives one space to be in equilibrium with oneself again. Thus, radical acceptance of the feeling is an effective method of “dialing down” one’s empathy.
Most people are naturally empathic, but they lack practice. They set about practicing empathy, but are clumsy. Or they had a bad experience in relation to their own empathy or someone else’s (lack of) empathy. They develop a “flinch reflex” when it comes to practicing empathy. For such individuals, resistance to empathy replaces their spontaneous empathy. Most people use empathy every day, and do not need an expert to tell them what it is. Olympic athletes get a coach, but it is not because they are not good at what they do. They are good at what they do; and are striving to get to the next level of excellence. Few people claim to be really good at empathizing. Those persons who are practiced in empathy can be useful coaches in helping one to clarify definitions, engage the hard cases, and distinguish how to transform breakdowns of empathy into breakthroughs that make a difference.
Using empathy—practicing empathy—sometimes means being used by empathy. Yes, empathy uses us.
“Being used by empathy” means that the person has trained in being empathic, so that the person has a level of mastery that allows the person to be empathic (or not) without thinking too much about it. Empathy has become practiced, habitual, and automatic.
There’s what we know we know about empathy. There’s what we know we do not know about empathy and hope to find out. Where did the word come from? What are mirror neurons anyway? How does one expand one’s empathy?
Finally, there is what we do not even know we do not know about empathy. The third area is where this book and its training operates—what we do not even know we do not know: our blind spots about empathy; our vulnerability, shame, and cynicism in relating to others; and our resistance to empathy.
Empathy requires that one get “up close and personal” with other people. Other people can be notoriously difficult, irritable, dishonest, manipulative, apathetic, too pushy, or contrary. Other people resist being on the receiving end of empathy, because being understood makes them feel vulnerable.
If someone understands me, really understands me, then he can use what he understands about me to take advantage of me. Now an authentically empathic person would not do that, but the world is not known for being filled with authentically empathic people.
Well-intentioned persons sometimes simply misunderstand what empathy is and are resisting something else that they happen to call “empathy.” They mistake the breakdown of empathy in emotional contagion, conformity, projection, distortion, mind reading, or lack of responsiveness, for empathy proper, and throw out the baby with the proverbial bath water. The empathy lesson in confronting resistance to empathy is direct: remove the resistance to empathy, and empathy comes forth, develops, and blossoms. Empathy expands.
Overcome resistance to empathy: empathy expands
Another person’s blind spots are easy to see, but one struggles to catch a glimpse of one’s own. Thus, one of my own blind spots about empathy comes into view, albeit in my peripheral vision. When I do not get my way, I have the thought that the other person (or the world) is unempathic. This is of course absurd and self-serving, though, heaven knows, empathy is unevenly distributed in the world. The empathy lesson? Wherever there is empathy, can narcissism be far away? (No.) Thus, I clean up the thought—give it up, distinguish it as not helpful, let it go. But no matter how may times I give it up, the next time I am frustrated, it seems like there is that thought again, coming into view like the grin on the Cheshire cat. Only now it becomes an inside joke, and a challenge to earn my empathic wings everyday.
This lesson is easy to express, hard to do. The devil is in the details. One has to descend into the hell of one’s empathy breakdowns in order to emerge from the refiner’s fire of self-inquiry with renewed commitment to empathy, relatedness, and community. This sounds too hard. No one said it would be easy.
How to start? One begins by introspecting. Acknowledging one’s own lack of integrity and inauthenticity in the matter of empathy. Like the labors of the mythical hero Hercules, there is a whole lot of shoveling of manure to be performed.
Cleaning up broken interpersonal relationships is on the agenda. Repairing integrity outages and inauthenticities is in order. Empathy training includes the requirement to go out into the world of one’s relations with other persons and engage and practice.
The very idea of resistance to empathy inspires resistance. The idea of resistance to empathy requires motivation.
What could that even be? Resistance to empathy seems to make no sense. It sounds like resisting motherhood, puppies, or apple pie.
The idea that some people would resist empathy is surprising. Very surprising. What’s not to like about empathy? A great deal it seems. Even within this way of talking, appearances can be deceptive. Puppies make a mess on the new carpet. Apple pie is delicious, but it makes one fat. Mothers are wonderful people. The human race owes its existence to those who are mothers both individually and as a community; but motherhood is a damn tough job, not withstanding its many rewards. Mothers require a lot of support. Volunteers?
In general, receiving empathy is like getting a gift; providing empathy requires effort. Getting empathy is a benefit. Providing empathy requires listening to the other person, attending to one’s introspective reaction to the other person, managing the increase in tension, living with the uncertainty of being open to the other person, being vulnerable, and risking misunderstanding. This is why providing empathy inspires resistance. It requires work.
On the other hand, receiving empathy from a committed listener has been compared to sinking back into a warm bath. It is relaxing. It reduces stress. It is restorative of one’s emotional equilibrium. However, even in a one-on-one conversation, receiving empathy sometimes feels like being publicly acknowledged and recognized at a banquet. It has its uncomfortable side.
It is not always easy to be explicitly acknowledged and recognized for one’s contribution. One may feel ambivalent about being exposed and vulnerable. So even receiving empathy, though properly regarded as a benefit, has its conditions and qualifications; and some people are made painfully self-conscious by being acknowledged.
Whether one is giving empathy or receiving it, empathy has its dark side. If one is committed to giving empathy—being empathic—one is vulnerable to burnout, empathic distress, or “compassion fatigue.” If one is on the receiving end of empathic receptivity, though a restorative experience, one is still exposed in one’s potential weaknesses and limitations. One feels vulnerable to misunderstanding by the other person, to whom one has exposed oneself emotionally.
At a deeper level, resistance to empathy lives in our individual and collective blind spots about our dear self. Where there is empathy, can narcissism be far away? “Narcissism” is a way of relating to oneself. The mythical Narcissus was an attractive young man. He was so enamored of his own reflection in the mirror-like surface of the pond—this was before the invention of “selfies”—that he did not see the dangers of his surroundings. In different versions of the myth, Narcissus either fell into the water, drowning in his own image of himself, or he was consumed—metaphorically eaten—by the lion of his narcissistic desires, who also frequented the watering hole.
The empathy lesson of the myth of Narcissus? Empathy requires de-emphasizing “the dear self.” Even for someone committed to giving empathy such a de-emphasis of self-love is not automatic. When the empathy being delivered includes recognition, people struggling with self-esteem issues—either too much or too little—find it challenging just to accept the acknowledgement. “Naw, it wasn’t nothing—just doin’ my job.” It is not easy to be acknowledged, and therein lies resistance to empathy, too. Though receiving empathy feels good, it is not easy to open up to another person and acknowledge one’s personal issues, sufferings, sources of shame, or struggles.
In every instance of resistance to empathy, the empathy lesson consists in identifying, engaging, reducing, managing, or eliminating, the resistance to empathy by interpreting the resistance; driving out cynicism, shame, guilt (and so on); saying what is missing the presence of which would make a difference (such as respect for boundaries or contribution); and being open to the possibility—of expanded empathy.
When the resistance is reduced, empathy has space to expand, which it does so spontaneously as well as through providing explicit practices, tactics, strategies, and training.
The qualities that make organizations successful are not always the qualities that enhance their empathy. I am so bold as to assert this generalization applies whether the institution is a tax paying public one, listed on the stock exchange, or a nonprofit, community organization. Whether the corporate mission is to deliver value in manufacturing automobiles or to serve the community by collecting and distributing whole human blood to sick people, the ultimate truth is: no money, no mission.
Yet to say that the purpose of one’s business is to make money is like saying the purpose of life is to keep on breathing. Well, okay. The two are closely related. Definitely, don’t stop breathing. But somehow “don’t stop breathing” is not very useful as life guidance; and, likewise, “make money” is not a useful business strategy.
The ongoing process of living—or doing business—should not be confused with the purpose, vision, strategy, and meaning of the activity in the direction of excellence, whether in business or the community.
In most successful organizations, expanding revenue is a result of a successful strategy—applications and implementations that deliver value—and satisfy the demands of the customers, employees, and stakeholders. The expanded revenue is the effect of getting the vision and implementation just right, not the cause of it.
Successful enterprises of all kinds have to handle navigating an intricate, complex network of rules assigned by government, law enforcement, taxing authorities, and non-governmental special interest groups. Business and nonprofit enterprises must contend with competing organizations that assert and authentically believe that they can provide the product or service at lower cost or higher quality. Within the enterprise itself, the organization must balance the personalities of the leaders, individual contributors (workers), and stake-holders, who make up the organization.
An inherent challenge exists in building organizations and crafting an administrative structure that actually functions; and then getting the administrative structure—the bureaucracy—to act in a responsive and balanced way to customers, employees, and stake-holders.
Economies of scale that require fitting people into functions that can be substituted for one another to increase efficiency rarely expand empathy, because empathy consists in recognizing differences in individual contributions.
Hear me say it, and not for the last time: the things that make us good at business, including the corporate transformation of American medicine and education, do not always expand our empathy. What to do about it? The battle is joined. The recommendation?
Let your customers, constituents, or stake-holders train you in empathy: Realize that if you do not respond empathically, the customers are just going to go quietly to the competitor that does. Empathy is good for business. If the customer has a complaint that he is having trouble expressing, then use one’s listening skills to get to the bottom of things.
If the customer expresses anger, know that empathy is one of the best methods, bar none, of deescalating conflict and soothing anger. “Gee, it really does sound like you have not been well treated. Let’s see what we can do to make things better” [or words to that effect].
Still, I do not know of a single organization that as of the date of publication of this book, when making decisions, serving customers, documenting complaints, closing sales, managing conflicts of interest, asks: “What would the empathic response be?”
To be sure, aspects of the empathic response are included in such common factors as “be respectful to customers,” “be helpful to clients,” “keep one’s agreements,” “strive to deliver value.” Empathy is already in the mix, and many customers are willing to pay a premium for empathic services even if they do not use the word “empathy.”
The astute businessperson, committed to expanding the enterprise, knows that “if you want to gather honey, do not knock over the bees’ nest.” This is distinct from empathy, but not by much. Thus, the task is to nurture the seeds of empathy already present in abundance, but lying in hiding in cynicism and denial, while making the case that smart organizations build and deliver value empathically.
The legendary Marshall Field, one of the inventors of the department store, on which the sun is now setting, and a kinder, gentler robber baron of capitalism, is famously quoted as saying, “Give the lady what she wants.” It made Field rich, and his workers well off. It is perhaps a sign of the times that Field’s was purchased by Macy’s some years ago, which has struggles of its own in a world in which retail, having been “Amazoned,” is not what it used to be. So the tenuousness of the market value of empathy can be measured by the mark down of the once storied Field’s Enterprises in the face of Internet shopping.
An alternative redescription of the fire sale of Marshall Field’s flagship stores is that individualized, personalized, customized one-on-one service has moved to the ultimate free market, the Internet, once again, disintermediating the disintermediators. I would not rule out expanded empathy in online cyberspace, but, even allowing for the convenience of shopping naked, it is a work in progress.
Even in mild and efficient bureaucracies, people misuse organizational rules and paper work to create resistance to empathy. Passing the buck, “Not my job,” “I’ll have to get back to you,” “We received no such request,” “I don’t know, and I can’t tell you when,” are common responses. Bureaucrats (which used to mean “office worker,” but is now a devaluing term) address such pseudo-answers not only to customers, but also to their coworkers and managers.
Resistance to empathy uses organizational rules and regulations to build protective walls, instead of teamwork. Without concern for the other person, bureaucracy unwittingly creates obstacles that prevent workers from being present with one another.
Mutually implementing and contributing to agreements with the organization and one another is not a priority. Perpetuating the bureaucracy is. Managing permissions and gaming the system occur to avoid work, rework, and overwork. The threat of uncompensated overtime and overwork consumes the energy required to get the job done.
People automatically and unwittingly fall into resistance to empathy, exploiting the tendency to be territorial.
The organization itself can show up as the unempathic authority figure—like the unempathic parent, who leaves the child feeling devalued, depressed, and de-energized. In response, an individual pushes back against the organization and its rules, disagreeing and speaking truth to power.
Rarely does the organization respond empathically to the individual, but rather urges the individual to conform. The individual asks for an accommodation. “Power” exhorts the individual to comply. “Power” says, “I did not make up the rules—I just enforce them.”
The individual states that the organization exists to serve the stake-holders, not to perpetuate its own rule-making. But rule-making has a way of becoming habit forming, if not addictive. Whenever a problem, issue, or breakdown occurs, the tendency is to try to formulate a rule to cover the new case. If the individual continues for any amount of time in a state of non-compliance, then “power” tends to experience a loss of authority, which is deeply threatening and unacceptable to “power.” Power escalates efforts to force compliance. Power imposes sanctions, increasing the cost to the individual. Empathy struggles to make a difference and be heard.
Compliance is definitely trending. This is the age of compliance. And there is nothing wrong with compliance as such. Stop on red; go on green. Yet sometimes so many “shoulds” exist that doing one’s job can end up on a slope of diminishing returns. Filling out the required paperwork takes an increasing percentage of the workday.
For example, some people train to become nurses because they care about other people, and they want to take care of them and their health. However, when virtually every patient encounter has to be documented to satisfy compliance regulations, then an eight-hour workday includes hours of electronic documentation. Many nurses are saying, “This is not what I signed up for.” Engagement—a synonym for empathic nursing encounters—struggles for space to make a difference.
“Compliance” includes conforming to acceptable boundaries and limits. No one is saying break the rules. No one is saying disregard boundaries. Rather one is saying relate to rules and boundaries empathically. But what does that mean? Even if the light is green, look both ways for emergency equipment or an inattentive driver running the light. Don’t be dead right. And as applied to empathy?
Empathy is about traversing boundaries between individuals. But these include not only boundaries between the self and the other, but boundaries between those in a position of authority and subordinates, between insiders and outsiders in communities, and between those who are insiders and those who feel left out—or are actually marginalized and have become invisible.
Humor and empathy versus cynicism
Cynicism and denial are the enemies of empathy. The empathy lessons are simple: Empathy up, cynicism down. Humor up, empathy up. Yet in the face of life’s challenges, setbacks, and struggles to survive, everyone gets cynical on a bad day.
Ground zero of cynicism and humor is Scott Adam’s Dilbert cartoon. It is wickedly funny, because it expresses more than a grain of truth about dysfunctional, anti-empathic organizations.
In one classic example, the pointy-haired boss says that from now on the organization will assign job functions based on the Myers-Briggs Personality Test (MBPT). For those readers who may not know, the MBPT is the test that distinguishes introversion and extroversion, thinking and feeling, and related categories. The boss continues: “For those of you who do not have a personality, one will be assigned by the human resources department.”[ii] I must say that I am deeply ashamed of myself—I can’t stop laughing.
In humor, stress and psychological tension are created by violating a standard—saying people in corporate cubicles have no personality—and then the stress is released in laughter by the mechanism of the joke such as a pun, double meaning, or violation of expectations.
Humor is closely related to empathy in that both humor and empathy cross a boundary between the self and the other. However, unlike empathy, in which the boundary crossing occurs respectfully, with acknowledgement of the other person’s contribution or struggle, and with recognition of humanity, in humor the boundary between self and other is crossed with aggression, put down, or (in other cases) sexuality. The rule? The more objectionable the joke is, the funnier it is. The put down, “If you do not have a personality, one will be assigned by HR” is indeed wickedly funny; but it is also deeply debunking of the corporate world (and shaming of the individual), in which people come to feel like a gear in an inhuman mechanism.
So empathy for the long suffering inhabitants of corporate cubicles, whose personalities are at risk of being erased, does come to the surface after all. The laughter largely dissolves the cynicism. It is a commonplace in the organizational world that people function as replaceable cogs in a well-oiled machine. Therefore, the cartoon is an example of what not to do. Cynicism and shame drive out empathy; and, more importantly, driving out cynicism and shame create a space into which empathy stands a chance and can expand spontaneously.
How then does one drive out cynicism, shame, denial, and so on? The short answer is by calling it out, acknowledging it, interpreting it, and offering an alternative point of view. Not “alternative facts,” which have come to mean “spin” and “deception”; but an alternative perspective. It is now cynicism versus empathy in the organization.
For example: “Given the challenges we are facing, it is easy to become cynical. However, I have an alternative point of view. If we adhere to our commitments, then the way forward is clear. Not easy, but clear. We have to … remember who we authentically are, serve the customer, be inclusive, expand the community, be guided by our empathy (and so on). We have to live up to our commitment that everyone who comes in contact with the organization, even if we cannot completely solve their problem, is left whole and complete, treated with dignity and respect (and empathy).”
In the face of pervasive cynicism, it takes courage for a person to responds empathically. Such a person may be perceived as a threat to the prevailing, default attitude of “I won’t call you on your lack of authenticity if you don’t call me on mine.” Such a committed person is at risk in standing out from the crowd; but such a person just might provide the leadership, gather the power to make a difference, get the job done with grace and ease under pressure—and get a promotion.
One does not even have to stop being cynical, since it is so pervasive, but one has to adhere to one’s commitment to making a contribution, work to make a positive difference, and deliver value on one’s agreements.
Cynicism is shown up for what it is: taking the easy way out. The practice of empathy is hard work.
It is not only the executive suite, but also the front and back office and every part of the supply chain in between that are staffed by harried people pushed down into survival mode by a cruel gig economy where empathy is not a priority. Of course, empathy gets paid lip service. Please pardon the double negative—one dare not not pay empathy lip service.
However, all-too-often, empathy is too messy. It is too complex. We are not even sure what empathy would mean in an organizational context. We need results now. Suck it up. Get over it. Conform! Nor is there anything wrong with conforming as such. Submit your expense report on time. Even the customer wants to conform, if only he could get the product to function as designed. It is just that empathy is too time consuming, which means—it is too costly.
Yet never was empathy more important than when it seems there is no time for it. Positively expressed, as with most forms of resistance, the method of overcoming it is to call it out and interpret it. Once visible and explicit, it is less formidable.
The empathy of cross-functional teams, managing by walking around, making a contribution, building the bigger team, being inclusive of all the stake-holders, communicating goals and connecting the dots between individual accomplishments and the objectives of the entire organization—these create a clearing in which empathy shows up and makes a profound contribution to the success of the organization.
In addition, one’s employer is not one’s parent. Remember the sign in the common kitchen that says “Your mother does not work here—clean up your dirty dishes!”? Of course your mom told you that, too, and she did “work here” at home, and it still hasn’t snuck in.
Notwithstanding the rich comic possibilities, one’s employer and its leaders do indeed “work here.” Leaders provide powerful examples to whom we look for inspiration. This must give one pause about the state of leadership today. Just as children have to get empathy from their parents before they can give it to others, employees have to see and experience examples of empathy from their leaders to be effective in their own roles as individual contributors. The idea is not to be paternalistic, but to lead by example, the example of empathy.
The difference between banging on a stone and building a cathedral
Executives of all kinds have varying degrees of empathy and different attitudes towards it. It may sound like yet another burden that the CEO now also has to take the role of “Chief Empathy Officer.” This comes up for detailed discussion below in the chapter on the empathy application to “Business and empathy, capitalist tool.”
Meanwhile, when I am bold and ask executives what is the budget in the organization for empathy training and empathy consulting, they usually look at me with a blank stare or just say “zero.” However, when I ask what is the budget to reduce conflict, enhance teamwork, innovate and improve productivity, inspire participation, cause the staff to take ownership of the mission and honor their agreements, then the leaderships sees possibility where none had previously been present and makes it a priority to obtain a budget.
Simply stated, empathy training consists in surfacing the resistances to empathy, the pervasive fear and cynicism (and so on) in the organization that lurks just beneath the surface; interpreting the resistance, and driving it out: “It is perfectly understandable that you would be cynical, given what you have been through, but that is not who you (we) authentically are. Rather we are the possibility of [health, transportation, nutrition, education, retirement, housing, recreation, and so on (according to the mission of the organization)].”
What would it take to design agreements that overcome resistance and commit to aligning organizational and individual goals and then taking action to implement the agreements on an ongoing schedule? The empathy training consists in engaging in a sustained dialogue for possibility around agreements that work for everyone in delivering value.
In particular, overcoming resistance to empathy, expanding empathy, is on the critical path to eliminating or at least reducing organizational conflicts and dysfunctional behaviors. When staff, executives, stake-holders, and so on, expand their empathy for one another and for customers, they are able to deescalate confrontations and negativity; they avoid provocative and devaluing language; and they are able to head off dignity violations, all of which reduce the conflicts that literally suck the life out of organizations.
When employees appreciate the possibilities of empathy, they even try to replace office politics with professional behavior. Staff get more done because they can concentrate on doing their jobs, working smarter, and serving customers and coworkers rather than struggling with departmental politics.
In addition, expanding empathy—overcoming resistance to empathy—is on the critical path to building teams. Empathy is the foundation of community, and the team is nothing if not a community. In empathy, people practice giving acknowledgment and recognition for their contribution to the success of the team and the organization. Being inclusive does not always come naturally or easily to us humans, territorial creatures that we are. We oscillate between closeness and distance like a pendulum.
However, no organization can succeed without including every contributor and turning him or her loose to do the job at hand. Even in hierarchical organizations, where departmental boundaries are rigid, empathy works to demonstrate that good fences makes good neighbors but that gates are needed in the fences through which empathy can be practiced.
Expanding empathy is also on the critical path to innovation and enhancing productivity, because people feel gotten for whom they are as a possibility and as a contribution. They stop withholding and working in quasi-competitive isolation. When they get in touch with one another as possibilities, the business results take off.
Successful leaders know the importance of drawing on the talents of every contributor. When employees get a sense of how their role and contribution fits into the whole, they work to deliver on their commitments.
That is the key to improved productivity. People are generous in sharing their ideas for process and product improvement, because they feel confident their contribution makes a difference and is recognized. For example, two workers are going through the same motions, making the same gestures. An empathic milieu makes the difference between the one, who is banging with a hammer and chisel on a chunk of stone, and the other, who is building a cathedral. The worker’s gestures are exactly the same. The one is sentenced to hard labor; the other participates in greatness.
[i] Jodi Halpern. (2001). From Detached Concern to Empathy: Humanizing Medical Practice. Oxford: Oxford University Press.
[ii] Scott Adams. (1996). The Dilbert Principle. New York: Harper Business.
The Natural Empath Meets the Good Samaritan
A person can regulate his or her empathy up or down by crossing the street. The empathy lesson is that if you can cross the street to avoid the beggar, regulating your empathy down, then you can cross the street (as well as use other methods) to expand your empathy, regulating it upward. So don’t tell me that empathy cannot be dialed up or dialed down with practice. That’s the point: practice.
Crossing the street is what happened in another story with which many readers are already familiar. The story of the Good Samaritan, one of the parables of Jesus of Nazareth, tells of two people who crossed the street, and one who did not. In the story, a traveler was waylaid by robbers. He is left for dead by the side of the road. The first two persons—the Levite and the priest experienced empathic distress, and, crossed the street, passing by the victim.
The Samaritan, however, was not overwhelmed by the victim’s suffering. The Samaritan perceived the suffering; he had a vicarious experience of the suffering that did not over-stimulate him with suffering and cause empathic distress. The Samaritan saw a fellow human being; recognized the suffering humanity; and he decided to get involved.
Multiple empathy lessons are available here. First, to regulate one’s empathy, cross the street. This is an edgy and confrontational way of putting it, but it is literally accurate. Cross the street away from the neighbor to “down regulate” your empathy, and experience less empathic distress; and cross the street towards your neighbor to expand your empathy in the direction of creating an inclusive community of persons, who recognize the value of cooperation.
The empathy lesson is that the vicarious experience does not have to be overwhelming. Rather, with practice, one is able to shift one’s focus from suffering to neighborliness; one is able to shift one’s attention from suffering to making a difference and enhanced self-esteem, expanding community and shared humanity.
Crossing the street is not the only way to reduce one’s chance of empathic distress or responding empathically. One may imaginatively changes places with the survivor and reflect that one would want the other’s help if one were in a similar predicament. One may spontaneously and without thinking act impulsively to be helpful, because one’s upbringing has made such responsiveness a habitual practice. (I believe this was the case with the Samaritan.) One may reflect, “I am safe and the survivor is no danger to me and it is my turn to help out.”
Or, on the contrary, one may make a devaluing judgment such as “The guy deserved what he got.” Such a judgment would be inaccurate—and in this case it would literally add insult to injury—but such thoughts do occur among by-standers. The passers-by may have just been hard-hearted. One person’s empathy is another’s antipathy. The language speaks volumes.
The empathy lesson consists in distinguishing such a devaluing thought; acknowledging that thinking is profoundly different than acting and should not be confused with it. The empathy lessons is to take action coming from one’s authentic commitments to building community through empathy, not devaluing thoughts.
This story is an empathy lesson that also instructs us in the difference between empathy and compassion. The Samaritan’s empathy told him what the other person was experiencing; his compassion (and ethics) told him what to do about it.
This bears repeating: empathy tells one what the other person is experiencing; compassion (and ethics) tell one what to do about it.
We are usually taught to devalue the behavior of the Levite and the priest; and surely they do not win a prize. Yet in an alternative point of view, they were all-too-human. Seeing all that suffering embodied in the survivor, they just couldn’t take it. They succumbed to empathic distress.
They experienced a breakdown of their empathic receptivity, and were overwhelmed in a kind of instant empathy fatigue (not compassion fatigue).
In an alternative reading of the parable, the would-be rescuers dial down the granularity of their empathic receptivity, so as not to be too sensitive to the suffering, even as they get a sample of the suffering, which is needed to inform their humanity.
The Good Samaritan, who is a seemingly infinite source of insight, is called to his empathic neighborliness by the distress of the injured traveller. The traveller who had fallen among thieves and was beaten near to death creates the possibility of empathic community by his loss of human well-being. He has been reduced to a lump of suffering, broken, physical pain.
The Samaritan rescues the traveller; the traveller humanizes the Samaritan, calling him not just to the role of an altruist doing a good deed (though that occurs too), but to his possibility as a human being in relation to another fragile, suffering, dependent human being.
The stricken traveller, by his very being, gives the Samaritan his own humanness. This occurs precisely in making the Samaritan a neighbor in answering the question, “Who is one’s neighbor?” Such was the trick question that the Pharisees posed to Jesus, to which this parable is the response.
The Samaritan gives humanness to the distressed traveller in an intervention that defines them as part of the same community of fellow travellers—neighbors—on the road of life.
In an alternative retelling of the story suppose that the Levite and the priest were “natural empaths,” biologically predisposed to be sensitive to the pain and suffering of other people. They were endowed with a certain “delicacy of empathy,” and they feel the suffering of the world deeply. Perhaps too deeply. Some people report: “I am a natural empath—and I suffer because I feel the pain of others too acutely. I started out being empathic—but people took advantage of me—and even when they didn’t, I was just too empathic; I got overwhelmed with sensation and sucked dry—the result was burnout, compassion fatigue. Nice guys finish last—so do empathic ones.”
Thus, the lament of the natural empath.
Empathy becomes a burden, because the world is filled with so much suffering. Yet if the person uses avoidance to “down regulate” their empathy, the person feels guilty because the individual believes that what she is doing is unkind, thoughtless, lacking in fellow feeling, and—unempathic.
So the natural empath falls into a double bind, and her suffering seems inevitable. She is over-whelmed by too much openness to the suffering of the other person or over-whelmed by guilt at not living up to her own standards of fellow-feeling and ethics.
These statements imply that empathy cannot be regulated through training, albeit a training that goes in the opposite direction (from too much empathy in the moment to less empathy) than that required by the majority of people, who are out of touch with their feelings and need to “up regulate” their empathy. The empathy lesson for the natural empath is to be more flexible about her ethical standards, while attempting to tune down her empathic distress.
Some people are skeptical that “natural empaths” are all that they say they are. Natural empaths in their natural state assert that they feel overwhelmed and distressed by other people’s thoughts and feelings. I see no reason to doubt such statements. However, to some critics, a redescription of the natural empath asserts that the latter are “irritable” and “hypersensitive.”
Empathy is recognizing and understanding the other’s perspective and then communicating that understanding to the other person. Someone who is unwittingly, even helplessly, swept along by the other’s feelings is not really being empathic. Over-identification, not empathy?[i]
The way out of this apparent impasse is to consider that the natural empath does indeed get empathic receptivity right in empathic openness to the other’s distress, but then the person’s empathy misfires.
Whether the misfiring is over-identification, resulting in empathic distress, depends on the description and redescription. Standing on the sidelines and saying “Try harder!” is easy to do. Where is the training the person needs when they need it?
The recommendation regarding training? Most people need to expand their empathy; some people—natural empaths—need to contract (or inhibit) their empathy. Empathy regulation—learning to expand and contract empathy—is the imperative in either case.
Instead of complaining about being an overly sensitive natural empath (however accurate that may be) do the work of practicing empathy by “down regulating” one’s empathy in a given situation, transforming empathic distress into a vicarious experience. Instead of complaining about not being pre-disposed to empathy, get up and do the work of practicing empathy, which for most persons means “up regulating,” expanding their empathy.
[i] Lou Agosta, (2018). Empathy Lessons. Chicago: Two Pairs Press: Order empathy books click here: https://rb.gy/avwkb7
Review: Galileo’s Middle Finger: Speaking Truth to [Transgender] Power – and Power Talks Back
A scientist has not been burned at the stake in over 350 years – and even then it was Giordano Bruno, not Galileo. Find out how Professor Alice Dreger (PhD) become an advocate for survivors of intersex sexual reassignment surgery and she becomes a strong candidate to be burned in effigy by those for whom she was advocating.
This is a reposting of a book review from 2015, now included as a podcast (originally recorded on April 29, 2015 with Alice Dreger, PhD, Professor of Medical Humanities, Northwestern Feinberg School of Medicine).
With transgender dynamics, identity, politics, and everything exploding in the headlines, the need for empathy around sexual identity and related issues is even more urgent and timely today than when originally broadcast.
Join me for a conversation with Alice Dreger about the conflict between scientific evidence and some interpretations of social justice and “empathy” (in quotation marks). Dreger starts out as a graduate student exploring the condition [previously] known as “hermaphroditism,” people born with sex organs that are ambiguous as to male or female, now called “intersex.”
In reading the text books studied by her medical student husband, she discovers the interventions performed to “normalize” people sexually into the two canonical categories of male or female. The parents usually follow the recommendations of the physician-surgeon who are articulating a supposed community standard that one’s genitals should unambiguously be either male or female. Dreger discovers that many of the people whose genitals were surgically transformed were subsequently lied to about their natal [birth] sex by well-intentioned doctors and well-intentioned parents following the well-intentioned doctor’s guidance. Thus, the road to hell. Find out what happens when Dreger’s research surfaces evidence that does not align perfectly with the interpretation of a social justice agenda.
This is a powerful and disturbing work. Dreger delivers a compelling narrative. A penis smaller than a person’s adult thumb or clitorises larger than one little finger, according to (some) conventional wisdom, have got to go. I am not making this up. The standard procedure was to surgically “delete” the offending member and surgically construct [some version of] the female genitals. This will, of course, resonate with Freudians everywhere as something motivated at the deepest levels of the unconscious. Not so Freudian is the proposition that if sex assignment from male to female and the raising of the infant as one rather than the other sex is the consequence, so be it. (Dreger is not interested in Freud in this text – that is my hobby.)
Dreger marshals evidence that people whose genitals are not surgically transformed as infants – but who have non-standard but otherwise healthy functioning genitals – are not worse off than those whose genitals were modified, and in many cases flourish. In at least one case, where the boy could not urinate standing up – and write his name in the snow with the stream of urine – due to the opening to the urethra being beneath the pen, the result of the surgery often produces a “cripple”. Yet the surgery continues to be performed. In other instance, the major concern expressed by the medical text books was that the child would become lesbian or gay. Ouch.
Dreger “goes to bat” for these intersex individuals, recovering their narratives out of medical records and journals where they had been documented as cases. She advocates for them. She lobbies, blogs, publishes in the popular press. Then the unintended consequences hit. Some of those for whom she is advocating don’t like some of the evidence Dreger publishes. It is not sufficiently “on point” about transgender issues being exclusively a function of a man’s brain born in a woman’s body or vice versa. The idea that a man could love himself as a woman and so want to become a woman does not compute.
As one might expect, research produces subtle nuances that require more than a sound byte or even a blog post. Suddenly Dreger finds herself the target of anger from the advocates for whom she was lobbying. It is not pretty. It gets ugly. Think self-righteous indignation as an expression of narcissistic rage and having one’s deeply felt values questioned by the evidence. There is no easy way to say it: some advocates of social justice seem to feel that the end justifies the means. The “means” include rampant forms of bullying and in-your-face confrontation, including charges of dubious ethical violations, invalid research, fictional claims about the researcher’s relations with his or her children and family, and the posting of toxic gossip on the Internet. The cause may be righteous, but the behavior is wicked and mischievous if not heinous.
Dreger survives and is vindicated. But then she begins to wonder if her experience of the collision of scientific evidence with advocacy and versions of its conventional wisdom was exceptional. Like most survivors she asks: “Is it just me?” It is not. It reminds her of the conflict between Galileo and the sedimented beliefs of the Church of his time.
A point that underlies Dreger’s work and may usefully be made more explicit: The facts of empirical science are fragile. Not only can they be shouted down by bullies, purged by tyrants such the Italian Inquisition of the 16th century, or simply ignored by the average person, the facts can also be set upon by academic, university, or institutional agendas more dedicated to building a corporate brand – and being financially well funded – than attaining an evidence-based version of the truth.
(An early version of this thesis, perhaps unknown to Dreger, is Hannah Arendt’s work on Truth and Politics. Not a historian of medicine but of political theory, Arendt makes the powerful point that if all versions of Euclid’s Geometry had been destroyed, mathematicians would still be able to recreate formal geometry out of the a priori forms of space and time; but if Stalin had really succeeded in purging all examples that such a person as Leon Trotsky had existed, then we really never would have heard of such an individual’s factual existence. Facts are fragile. )
A case in point. It is conventional wisdom since Susan Brownmiller’s Against Our Wills (1975), that rape is primarily an act of power by the perpetrator (usually a man), not one of sex. While not primarily a scientific treatise, it becomes the basis for research that gathers sufficient evidence and the thesis “power not sex” becomes “conventional wisdom.”
Enter a young (male) scholar who has a strong hunch he can prove an exception to the rule. No, sometimes rape is motivated by sex. Sometimes a guy, who has no prospect that the intended woman would have sex with him (but who he desires sexually) decides to use force. This naïve academic sees a dissertation topic that is a cut above the usual scholarly drivel. A dissertation is delivered to that effect. Not only does all hell break loose – he is silenced by angry activists – but it gets worse. The phone rings. It is a prosecuting attorney needing help with a case.
The District Attorney is bringing charges against a perpetrator, an alleged rapist standing trial for his crime. The defense is arguing effectively that science has shown that rape is about power, not sex. The perpetrator could not possibly have been motivated to the crime by sex. Science says so. Wait a minute. Rape is never about sex? It is now a defense against rape that there was no other motive than sex?
Since 1975 we have seen date rape and the use of incapacitating “date rape drugs” such as anesthetics facilitate the violation. Surely advocates and scientists can encompass the possibility that sometimes rape is about power, sometimes it is about sex, and sometimes, it is both (p. 125). Don’t be too sure. There is a deep lesson about human nature here. Constant dialogue is needed to keep people in rational communication without distortion and manipulation. The desire to be righteous and justified is pervasive and extends across all political spectrums. The ability to listen has rarely been in such short supply.
Another case. Napoleon Chagnon writes an innovative and disruptive work of anthropology (Yanomamö: The Fierce People). He argues that Margaret Mead’s vision of a peaceful coming of age in Samoa in a sexually liberated version of a hippie-like commune may not be the only paradigm of the life of native indigenous peoples. (Mead herself was subjected to a debunking, the factual basis of which turned out to be, shall we say, less than rock solid.) The Yanomamö in South America are more like warring bands of Hobbes’ “war of all against all” or the tribes of the Peloponnesian peninsula, with Achilles throwing a narcissistic fit – “I stole her fair and square” – because Agamemnon took his plundered woman.
Chagnon is a virtual Dreyfus Affair in the American Association of Anthropologists. Alfred Dreyfus (you may recall) was stripped of his epaulets, his campaign badges ripped off his chest, and he was banished to Devil’s Island (my metaphor, not Dreger’s). Years later, Chagnon is vindicated (as was Dreyfus) and “rehabilitated.” But only after years of upset, suffering, and the monumental expense of mounting a defense against false accusations as recounted in his My Life Among Two Dangerous Tribes – the Yanomamö and the Anthropologists. The bottom line? According to Dreger, in addition to the political infighting, wicked and mischievous gossip, and an alleged series of narcissistic injuries unintentionally committed by Chagnon against colleagues, it was politically inexpedient to represent indigenous peoples as warlike.
Dreger documents in detail the appalling political intrigues, plots misfired and rebounding onto the heads of the perpetrators, and the narrow mindedness of academics who ought to have adhered to scientific standards rather than tit-for-tat gamesmanship. Dreger’s work is definitely a page turner, reading like a spy novel or an account out of Kafka’s The Trial. Speaking personally, it made me paranoid at points. I felt discouraged at the alternating narcissistic rage and petty retaliation enacted for real or imagined slights to which both scientists and advocates for social justice seem all-too-prone.
The drama goes on. It escalates. Maria New, MD, is a celebrity woman’s doctor of long service and, at least initially, significant distinction. Dr New advocates that early stage pregnant women take dexamethasone (off-label, though FDA approved to prevent miscarriage) when the parental profile shows a one in eight chance that the female fetus may have congenital adrenal hyperplasic (CAH)). Basically CAH means that the baby might be a “boyish girl” if left untreated. Heavens to mergatroid – a lesbian? But since there were never any controlled studies of the consequences of taking dexamethasone (dex), it is not clear if the cognitive impairment, the deformed genitals, other anomalies, were due to the action of the drug or whether the drug was simply ineffective for its off-label use.
Dreger believes she has an “open and shut” case of an ethical violation that research subjects were not informed that they were participating in what amounts to a experiment, a far cry from a “safe and effective” treatment. The FDA oversight representative embedded in the research teams raises a number of red flags. Her career is ended on a pretext, and Dr New transitions to a different university without so much as a warning in any file.
One thing is for sure. Taking the case to the FDA and the Office of Human Research Protection (OHRP) reveals a level of indifference, human clumsiness, and subtle, unexamined conflicts of interest and self-dealing that again approach’s Kafka’s The Trial. Appalling. By the way, if ones want to receive this treatment during early stage pregnancy with the hope of dialing down the masculinization of the fetus, it is still legally available from Dr New and her associates, though Dreger has made it her project to dominate the Google listings with warnings about the risks of the treatment.
Dreger’s point is that the use of dex to influence the process of masculization of the fetus is experimental as used off label (the “on label” use is not to treat CAH, but to prevent miscarriage, for which it seems to be effective). The women to whom it was given to treat CAH were never told and never signed an informed consent form to participate in what was basically an experimental use of the drug. “Safe and effective” remains unproven for CAH, and evidence to the contrary is emerging. However, what really put the kabash on the treatment with dex is that it has been branded an anti-Lesbian drug. More good news. It is not as bad as thalidomide; but possibly another DES fiasco in the making.
In conclusion, Dreger offers reflections inspired by the Founding Fathers of the early days of the United States and such politician-statesmen as Benjamin Franklin. No stranger to risk, Franklin was both flying a kite in a thunderstorm and building a structure of government capable of correcting its own errors (not on the same day). Thanks to such men, we are all better off than Galileo when speaking truth to power. Free scientific inquiry needs a free social and fair political space to flourish. Justice requires access to accurate facts and a way of testing evidence that distinguishes fact from fiction The truth is vulnerable to the influences and distortions of the social organization of power.
Granted that a scientist has not been burned at the stake for over 500 years, that is no reason for complacency. I could not help but think that Professor Dreger was well on the way to being a candidate, though admittedly the burning was “in effigy.” Bad enough! There have been many ruined careers and damaged lives due to bullying and political abuses. Dreger bemoans the “push down” of the press and investigative journalism – in short, the decline of the press beneath the pressures of a publishing market in distress, the Google-ad-industrial-complex, and on the Internet no one knows you are a dog. While the Internet is a multi-edged sword and sends fear into the hearts of tyrants everywhere, it is easy to abuse. It is a dubious format for rational discourse and evidence-based anything. That should not stop one from posting her or his peer-reviewed research (this is not an example of that) but it means one must also mount the soap-box on a regular basis and speak truth to power.
Alice Dreger. (2015). Galileo’s Middle Finger: Heretics, Activists, and the Search for Justice in Science. New York: Penguin.
(c) Lou Agosta, PhD and the Chicago Empathy Project

