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Review: Empathy and Mental Health by Arthur J. Clark

Empathy and Mental Health: An Integral Model for Developing Therapeutic Skills in Counseling and Psychotherapy. London: Routledge 2022 Electronic Version

As a young man, Arthur J. Clark heard Carl Rogers speak and was inspired to devote his life’s work to applying empathy in education, counseling, and talk therapy. This book is the distillation of years of experience and learning, and we, the readers, are enriched and even enlightened in this original synthesis of existing ideas on empathy. It is fully buzz word compliant, diligently calls out the limitations and risks of empathy, and guides the readers in expanding their empathy to make a difference in overcoming suffering and mental illness. It takes a lot of empathy to produce a book on empathy, and empathy is evident in abundance in Clark’s work.  

As noted, Clark’s academic background is in education, as was Carl Rogers’, but the reader soon discovers Clarks’ work with empathy to be generously informed by Freud, Ferenczi, and Adlerian psychoanalysis. Thus Clark quotes [Alfred] Adler (1927): “Empathy occurs in the moment one individual speaks with another. It is impossible to understand another individual if it is impossible at the same time to identify oneself with him” (Clark: 20). At this same time this reviewer was enlivened by the application of distinctions to be found in the Self Psychology of Heinz Kohut and the latter’s colleagues Michael Basch and Arnold Goldberg. This brilliant traversal of the practice and conceptual landscape of empathy inspired Clark’s life work, and is on display here.

The book is filled with short segments of transcripts of encounters between counselor/therapist and client. To the point that empathy is much broader than reflecting feeling and meanings, examples are provided of empathic encouragement, empathic being in the here and now (immediacy), empathic silence, empathic self-disclosure, empathic confrontation, empathic reframing, empathic cognitive restricting, empathic interpretation. Clark’s work with empathic reframing, cognitive restructuring, and interpretation are particularly useful (Clark: 105 – 106). 

“Empathy” is not so much a substantive as a modifier – a manner of being that applies across a diversity of ways of relating to the other individual. (It is a further question, not addressed by Clark, as to the status of these vignettes. Are they disguised, permissioned, ideal types, some combination thereof? Just curious. In any case, they work well and remind me of M. F. Basch’s vignettes in the latter’s Doing Psychotherapy.)

Clark makes reference to the celebrated video (e.g., widely available on Youtube) of Carl Rogers, interviewing the real-world patient “Gloria” about her relationship with her nine-year-old daughter “Pammy.” Rogers’ empathic listening skillfully turns the focus from Gloria’s presenting dilemma of how much information about sex to share with her inquisitive nine-year-old daughter, Pammy, into a willingness on the part of Gloria’s to call out her own blind spots and conflicts over sex. Rogers’ empathic responsiveness shows the way for Gloria to recapture her own integrity around adult sexuality so that she can provide Pammy with the appropriate sex education the child needs, regardless of the details that may be relevant only to the adults. And Rogers does this in about twenty minutes, not months of therapy.

At this point, it is useful to give Rogers’ definition of empathy (p. 11): “To perceive the internal frame of reference of another with accuracy and with the emotional components and meanings which pertain thereto as if one were the person, but without ever losing the ‘as if’ condition.” Rogers was definite about excluding the perspectives of the practitioner in conceptualizing empathy in his person-centered approach to therapy. In this regard, he stated, “For the time being you lay aside the views and values you hold for yourself in order to enter another’s world without prejudice.”

Clark’s integration of the diversity of approaches to empathy in history, theory, and practice distinguishes subjective, object and interpersonal empathy: “Subjective empathy encompasses a practitioner’s internal capacities of identification, imagination, intuition, embodiment that resonate through treatment interactions with a client and empathically reflect the individual’s experiencing. Objective empathy pertains to the deliberate use of a therapist’s conceptual knowledge and data-informed reasoning in the service of empathically understanding a client in a relational climate. Interpersonal empathy relates to comprehending and conveying an awareness of a client’s phenomenological experiencing and pursuing constructive and purposeful change through the application of a range of interventions” (Clark: xiv).

Clark started out as a school counselor and he gives the example of the student who comes in and says “I hate school!” The reflection is proposed to be something like “You are feeling angry about school.” This demonstrates just how important the tone in which a statement is made can be. This could indeed be an angry statement, which takes “hate” is a literal way. However, it could also be an expression of contempt, disgust, cynicism, resignation, sadness, or even fear (say, since the student is being bullied). The empathy is precisely to acknowledge that the listener is far from certain that he does knows what is going on with the student and to ask for more data. “Sounds like you are struggling with school – can you say more about that?”

Not afraid of controversy or tough topics, Clark’s contribution is thick with quotations from the founding father of psychoanalysis – Adler and Freud and the literature Freud has been reading such as Theodor Lipps, to whom we owe the popularization in Freud’s time of the term “empathy [Einfühlung].  The subsequent generation of ego psychoanalysts is also well represented Ralph Greenson, T. Reik, Jacob Arlow (and Beres). 

Clark credits and recruits Ralph Greenson’s distinction of the therapist’s inner working model of the patient and uses it to enrich Rogers’ contribution to empathic understanding. “As empathic understandings evolve through therapeutic exchanges and assessment interactions, a model of an individual emerges that becomes increasingly refined and expansive. In turn, by ways of empathically knowing a client, the framework facilitates sound treatment interventions through the engagement of interpersonal empathy” (Clark: 88). Note that Clark aligns with the view that the countertransference is distorting/pathological as opposed to the total response of the therapist. There are many tips and techniques guiding the therapist diligently to monitor and control the countertransference neurosis. 

Since this is not a softball review, I note some issues for productive debate. For example, if Clark had allowed that countertransference included the therapist’s entire reaction to the client, including personal reactions which are not necessarily conflicted or neurotic (on the part of the therapist), then Clark would have been constrained to spend more ink on his own individual responses, empathic and otherwise. Such disclosure, which Clark otherwise separately validates as appropriate in context (and if not this context, then which?), would have enriched a text which otherwise reads like a textbook (and perhaps that was the editorial and marketing guidance).

Also useful is the therapist’s being sensitive to cultural differences and dynamics. In a brief transcript of an interaction between a privileged white school counselor and an African American 8th grader attending the college prep private school (Clark: 42), we are supposed to see objective cross-cultural empathy based on the counselor’s reading of some articles (not specified) on cultural differences. 

By all means, read up on cultural differences. However, I just see a rigorous and critical empathy (my term, not Clark’s), plain and simple. The counselor “gets it.” The student is afraid of being seriously injured or even killed by the criminal element in his neighborhood as he waits for the school bus. Is this breakdown of policing in the inner city really in the cultural article? The counselor also “gets it” that the student’s feelings are hurt by being laughed at by his more privileged classmates because his mom is a house cleaner rather than an executive or doctor or lawyer. It is the counselor’s empathic response based on her empathic understanding of the student’s specific fear and hurt feelings that enables the student to deescalate from his problematic acting out. Even though, like most 8th graders, the student would be the last to admit he has been emotionally “touched,” he was. Thus, Clark’s empathy shines through in spite of his style-deadening need to accommodate behavioral protocols, evidence-based everything, and the plodding style of delivery consistent with training in schools of professional social work and psychology.

“Objective empathy” may seem like “jumbo shrimp,” an oxymoron. Nor is it clear how dream work, with which Clark productively engages, falls into the “objective” rubric. Yet it is a highly positive feature that Clark emphasizes and explores in detail the value of dream work. 

Let one’s empathy be informed by the context: “Consider, for instance, what are the daily struggles like for a client who meets the diagnostic criteria for a bipolar disorder or attention deficit [. . . .] When giving consideration to such challenges through a framework of empathic understanding, a practitioner calls upon reputable data and a spectrum of work with individuals from diverse backgrounds in order to generate a more inclusive and accurate way of knowing a client” (Clark: 35).  

And yet this precisely misses the individual who is superficially described according to labels, but has his own experience of bipolar or attention deficit. Empathy is precisely the anti-essentialist dimension, the dimension that is so pervasive in psychiatry and schools of professional psychology that replace struggling humanity with “You meet criteria for – [insert label].”

While Kohut is properly quoted by Clark as one of the innovators in empathy and Kohut’s concise definition glossing empathy as “vicarious introspection” is acknowledged, Kohut’s other definition of empathy as a method of data gathering about the other individual is overlooked. However, it aligns nicely with Clark’s description of “objective empathy.” Maybe my close reading missed something but why not just say “taking the other person’s perspective” is “objective empathy” as opposed to vicarious introspection (“subjective empathy”)? 

The subtitle promises “An integrative model for developing therapeutic skills [. . . ]” Clark substantiates the need for work in critiquing all those training program that model the skill of repeating back to the client words similar to those the client expressed. “In a meta-analysis of direct empathy training, Lam et al. (2011) found that the majority of 29 studies did not clearly conceptualize or define empathy, some did not describe training delivery methods, and almost all of the initiatives failed to present evidence demonstrating individuals’ propensity to behave more empathically after training” (Clark: 140). Clark’s discussion of reframing, cognitive restructuring, and empathic interpretation are relevant and useful in overcoming what amount to a scandal in psychotherapy training.

What Clark is trying to say is this: You think you are being empathic. Think again. A rigorous and critical empathy (my phrase, not Clark’s)  is skeptical about its own empathy. That does not mean being dismissive either of one’s own empathy or the struggle of the other person. It means being rigorous and critical. Empathy is made to shine in the refiner’s fire of self-criticism and a radical inquiry into one’s own blind spots. 

Clark does not escape unscathed from the behavioral and observation protocol dead end. The reader will seek in vain for self-criticism or inquiry into Clark’s own blind spots – instead the reader is awash in the extensive behavioral, cognitive behavioral therapy (CBT) attempts, albeit empathically deployed, to capture therapeutic encounters in a behaviorally observable or reportable protocol. Nor I am saying there is anything wrong with that as such. Yet might not the behavioral and observation protocol swamp precisely be the blind spot where the self-deception lives against which Rogers frequently denounces? To gather the honey of self-knowledge and empathic understanding one must risk the stings of distortion and disguise. 

Clark’s would be a different work entirely if he explored the college of hard knocks in which he forged the empathic integration. He is trying to make what is largely an artistic practice into a rule-governed scientific algorithm. It is worth a try and the reader must judge the extent to which Clark succeeds. Spending a lifetime preparing articles for peer-reviewed publications in education, psychology, etc., does not generally bring life and vitality to one’s practice, manner of engagement, or writing style. However, Clark’s richness of material, wealth of distinctions related to empathy, and organizing virtually every aspect of empathic research and published references goes a long way towards compensating for Clark’s work not necessarily being a “page turner.” Clark’s writing reminds the reader more of the Diagnostic and Statical Manual (DSM) – Ouch! – more than (for example) of D. W. Winnicot, Christopher Bollas, Arnold Goldberg, Freud, who was an expert stylist (granted much is lost in translation), or even Carl Rogers himself.

Thus, Clark’s integrated approach calls for “a diagnosis [as from the DSM] that represents the lived experience of the individual.” Agree. Clark gives an example where the therapist is interviewing Omar who has low energy, lethargy, lack of motivation, and hopelessness about the future. The diagnosis encapsulates and integrates a lot of Omar’s experience, and, though Clark does not say so, Omar may even be relieved to hear/learn that he (Omar) is not to blame for his disordered emotions (“major depression”); and Omar should stop making a bad situation worse by negative self-talk, verbally “beating himself up” in his own mind. The treatment consists in getting Omar to do precisely what the depressed person is least inclined to do – take action in spite of being unmotivated. If one is waiting to be motivated, absent a miracle, it is going to be a long wait. Maybe the empathic response is precisely saying this to the client, acknowledging how hard it is (and may continue to be for a while) to get into action on one’s own behalf. 

This is all well and good. However, narrowly or expansively empathy is defined it is the anti-DSM (diagnostic and statistical manual). The DSM has many uses, especially in aligning terminology such that the community is talking about the same set of criteria when it uses the word “generalized anxiety disorder.” It also has uses in requesting insurance reimbursements. In short, there is nothing wrong with the DSM-5 (2013) or any version – but there is something missing – empathy. In the case of empathy, the recommendation is to relate to the struggling human being who presents himself in therapy, not to a diagnostic label. 

Thus, Clark makes the case in his own terms: “From a humanistic perspective with central tenets focusing on respect for the individuality and uniqueness of a person, employing the DSM to categorize clients through a labeling procedure is thought to impede the growth of authentic relationships and empathic understandings of a deeper nature. In this regard, in a human encounter, perceiving a client through categorical frames of reference and symptomatic functioning hinders an attunement with the individual’s lived experiences and personal meanings. Moreover, applying a label to a client possibly influences a practitioner to shape preconceptions that are objectifying and forecloses a mutual and open-minded exploration of the contextual existence of the individual” (Clark: 27).

Though Clark does not say so, almost every major mental illness involves a breakdown of empathy. The patient experience isolation. “No one ‘gets’ me.” “No one understands what I am going through.” This is the case with most mood disorders, thought disorders, as well as those disorders typically described as “disorders of empathy” such as some versions of autism spectrum and anti-social personality disorders. 

One matter of editing detail may be noted, a consistent misspelling of the name of celebrated primate researcher, philosopher, and empathy scholar Frans de Waal. There are no “Walls” in de Waal’s name – or in his empathy! We will charge this wordo to the editors who otherwise perform an admirable job. 

Returning to a positive register, one of the most important takeaways from engaging with Clark’s work is that short therapy in which empathy is the driving force is powerful and effective. Clark does not specify the elapsed treatment in most cases, but I did not find one that was explicitly called out as being longer than fourteen weeks.

The emphasis is on the use of empathy in relatively brief psychotherapy – which is a powerful and positive approach that pushes back against the assertion that one needs cognitive behavioral therapy for relatively time-constrained encounters. Empathy produces quick results when skillfully applied. It is true that one of the great empathy innovators, Heinz Kohut, had some famous long and multi-year psychoanalyses; but these individuals were significantly more disturbed than Clark’s example of Anna, whose presenting behaviors were largely social awkwardness. 

A strong point of Clark’s work is his debunking of the caricature of Rogers definition of empathy (and indeed of empathy itself) as merely reflecting (i.e., repeating) back to the speaker the words that the speaker has said to the listener. There is nothing wrong as such with reflecting what the other person has said, especially if the statement is relevant or well expressed. However, the mere words are pointers to the other person’s experience and are not reducible to the mere words. This is not a mere behavioral skill of reflecting back language, but a “being with” the other in the complexity and depth of the other’s experience as refined in the therapist’s own experience, and that is something one can best learn in years of one’s own dynamic therapy. Additional processing of the other person’s experience is encapsulated by and captured in the other person’s words, but not reducible to the words. The aspects of empathic responsiveness, embodiment, acknowledgement, recognition, encouragement, immediacy, possibility, clarification, and validation of the other’s experience form and inform the empathic response and the reply to the other. 

A rumor of empathy is no rumor in the case of Clark’s work – empathy lives in his contribution to integrating the diverse and varied aspects of empathy. 

Edwin Rutsch interviews the author Arthur J. Clark:

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

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Transference and Empathy: Where Transference Was Empathy Shall Be!

Listen as podcast on Spotify by Anchor: https://open.spotify.com/episode/6ZFSOgaTe0x1fQvFuKFTgJ

[Note: the audio is not a exact transcript and sometimes covers the same or related material using different words]

While empathy is seemingly in exceedingly short supply in the world, you do not need a philosopher to tell you what empathy is. Every mother, every teacher with students, every business person with customers, every doctor with patients, every attorney with clients, every politician with supporters, every person with next door neighbors, knows about empathy. 

We shall start with the folk definition of empathy – take a walk in the other person’s shoes, and add one additional recommendation. However, first take off your own shoes before putting on the other’s – an action that is routinely overlooked – otherwise one gets projection, not an experience of otherness. 

The title statement echoes Freud’s celebrated slogan “Where id was, ego shall be!” Neither of these statements is an “either or” proposition. The id is not going away. Freud did not propose to abolish the id with the ego. It is not even clear what that could possibly mean. The idea is to expand the influence, control, and power of the second term (ego, empathy) over the first one (id, transference). The ego expands its power, including power over primitive aggressive and sexual inclinations; likewise, with empathy. Empathy expands its power in creating an opening for effectiveness and success in fulfilling and satisfying human relationships.

Let us define our terms. Transference is the carrying across of meaning from one context, model, or paradigm to another one. It is difference than metaphor, which means a “carrying across or beyond,” but perhaps not by much. We humans have a tendency to make things mean other things. We humans are “meaning making machines,” in the sense that we are a source of acts of conscious intentionality that brings meaning to our encounters with nature and our fellow humans in community. There is indeed something mechanistic about the way we automatically go about making things mean things. We can’t seem to stop doing it, which results in innovations but also distortions and misunderstanding. We take behaviors, conversations, and circumstances and try to make sense out of them by bringing meaning to them, which sometimes applies, but sometimes doesn’t. 

This definition of transference extends into the realm of so-called behavioral health and psychoanalysis (where it was initially and innovatively defined) into the contexts of diverse forms of psychotherapy, empathy consulting, professional coaching, or community building. At the risk of oversimplification, transference takes a cognitive, behavioral, or emotional response from one context, such as childhood or circumstances in the past that one had to survive, and uses it to respond to the therapist, coach, or trainer in a similar way. Typically this introduces distortion or extraneous issues into the relationship. 

The relationship between transference and empathy is under theorized. This is the case in spite of all the great psychoanalysts from Freud onwards commenting on both subjects, albeit sometimes in widely separated contexts and conversations. There are many reasons for under development of theory, both scientific and political, but it is largely due to the nature of the phenomena themselves. Transference as a distinction is largely structural, even though its emergence and transformation unfold in time in the process of a therapeutic psychoanalysis. Empathy as a distinction is largely a process unfolding in the therapeutic relationship, even though it has structural invariants. 

Empathy and transference are the opposite of one another. How so? In empathy one takes a walk in the shoes of the other person, the better to understand the other and relate authentically to the individual. There are many definitions of empathy, but they converge on the idea that empathy is an authentic form of relatedness. Get rid of the judgments, assessments, and evaluations, and be with the other person without applying labels, categories, and prejudices. 

Now transference is the exact opposite of authentic relatedness. The narrow definition of transference says take a pattern or relating from one situation – such as childhood or an experience in another context – and apply it to the current relationship or situation. The result is a distortion of the relatedness. The result is an inauthentic way of relating. In order to bring forth an empathic relationship one has to interpret and resolve the transference distortions. 

Let us take a step back. The implications of the relationship between empathy and transference, as noted, have not been much theorized. It is true that dozens of publication address empathy and dozens of publications address transference, and some even contain discussions of both empathy and transference (e.g., Racker 1968). But the specific interactions between being empathic in the transference and getting engaged in transference in being empathic in a clinical setting have not been much engaged. 

The recommendation? Think of the relationship between empathy and transference (or perhaps you say “the transference” as if it were a single unified thing) as a dance. Sometimes the one leads and the other follows and vice versa. The implications of the dance between empathy and transference are profound, but complex and entangled.

Lest one imagine these two phenomena – empathy and transference – are inevitably at loggerheads, consider the following example of convergence:

The patient comes in and says he saw the film, Elephant Man (directed by David Lynch (1980)) and he was deeply moved. The narrative is of an individua, David Merrick, suffering from Proteus Syndrome (often confused with Neurofibromatosis), which results in disfiguring folds of tissue on the head and other pulmonary and renal abnormalities. “Deeply moved,” by what aspect in particular, I asked? After being a freak, physically disfigured, lacking humanity, David Merrick meets the doctor who acknowledges his humanity. The recognition of humanity – “I am a human being – I am a man” is the most dramatic utterance – and the empathic moment. The client reports being moved to tears and having had a satisfying cry. Without further discussion, the client then spontaneously speculates, wondering if there was a parallel with our relationship, my having recognized something in him that others had not seen. Without going into confidential details, I had seen around or though the significant blind spot that kept him insensitive to an aspect of father’s behavior which was running his life and in a destructive way, yet not acknowledged. This enabled the client to shift his relationship to his life partner (as well as his father) and move on. The parallelism – transference – the recognition of humanity – empathy. 

To try to prevent misunderstanding, one must distinguish between transference in a narrow sense and transference in an enlarged sense. At risk of oversimplification, when transference was first discovered by Freud, it seemed like an obstacle to treatment, since the patient related to Freud as an authority figure such as The Father (in the case of a male patient) or as a seductive father figure (in the case of a female patient) whereas Freud regarded himself as a kind, even empathic, listener to the patient’s neurotic suffering. 

Eventually Freud realized that the patient was relating to him (Freud) as to an important figure from the patient’s past. Regardless of how Freud tried to treat the patient, the patient treated him- or herself with transference – but responding with a transference of meaning from one area of the patient’s life to the relationship with Freud. Just as significantly, Freud discovered that the patient was doing this in other areas of his life as well – towards his lady friend, towards his superiors at work, in a hundred and one ways in his life – with problematic results that caused the individual to seek treatment for his suffering and conflicts. 

For example, when the patient was a woman, the transference was not hostile but erotic. This can be motivated. If the reader saw Vigo Morgenstern play the middle-aged Freud in the film A Dangerous Method, then you know what I mean. This guy was hot! Though unlike Carl Jung, Freud was clear about professional boundaries: “[…] [T]he patient has transferred on to the doctor intense feelings of affection which are justified neither by the doctor’s behavior nor by the situation that has developed during the treatment” [1917, Introductory Lectures on Psycho-Analysis: 440 – 441]. It is in interpreting this transference – based on behavior different than that of the original seductive parental objects and suitable verbal feedback – that the cure of the neurosis is affected: “At the end of the analytic treatment the transference must itself be cleared away: and if success is then obtained or continues, it rests, not on suggestion, but on the achievement by its means of an overcoming of internal resistances, on the internal change that has been brought about in the patient” [1917, Introductory Lectures: 453]

Since this post is part of a larger project, I take the liberty of including several definitions of “transference” by leading figures who defined it. Those readers who wish less detail may skip ahead.

Thomas Szasz (1963: 432 – 443), who was otherwise a notorious psychoanalytic “bad boy,” denouncing the “myth of mental illness,” was an classic Freudian when it came to defining transference: “Freud conceived of transference love as an illusion because the situation in treatment cannot account for the origin of such feelings” [. . . .] [I]t [transference] is considered an expression of interest ‘basically’ directed towards childhood objects, deflected to the analyst or to the figures in the patient’s current life.”

Peter Giovacchini (1965: 287) writes that: “[. . . .] [T]ransference reaction refers to a person’s reactions to an object as they are determined by infantile unconscious factors. Viewing the object in terms of archaic imagos in a primary process orientation lead to irrational attitudes and distortions.”

Carl M. Grossman (1965: 249 – 250) defines transference in a broad sense that seems to go beyond the psychoanalytic context in a narrow sense: “[. . .] [Transference is] a universal human psychological characteristic which causes the internalized representation of certain objects – such as parents or parental surrogates from one’s infantile past – to be projected onto a succession of later, ostensibly unrelated persons. The transferring person then reacts to new objects with the anachronistically habitual reaction in adult life that he had had towards the originally cathected object in infancy.”

Ralph Greenson (1967: 151 – 152) asserts: “[. . . ] [Transference is] a special kind of relationship toward a person: it is a distinctive type of object relationship. The main characteristic is the experience of feelings to a person which do not befit that person and which actually apply to another. Essentially, a person in the present is reacted with as though he were a person in the past. Transference is a repetition, a new edition of an old object relationship” (pp. 151 – 152).” {TI: 339]

Leo Stone (1961: 66 – 67) writes “[…] [Transference is limited] to that aspect or fraction of a relationship which is motivated by persistent unmodified wishes (or other attitudes) toward an actual important personage of the past, which tend to invest a current individual in a sort of misidentification [. . . ] with the unconscious image of the past personage. It is essentially in appropriate to the current situation subjectively misunderstood as to genetic origin until analyzed, and tenaciously resistive to this analysis (pp. 66 – 67).” Stone further notes: “that a nuance of the analyst’s attitude can determine the difference between a lonely vacuum and a controlled but warm human situation, which does indeed offer these gratifications, along with its undoubted rigors” (1961: 21 – 22).” 

In short, transference is what happens when human do what they cannot stop doing – trying to make sense of situations by assimilating them to patterns from key patterns and expectations based on experience. What may have been helpful in one context to enable the person to survive or even flourish is less helpful and even harmful in other situations in that distortions and misunderstandings are introduced.

There is a broader sense of “transference” that developed, in which transference becomes the entire relationship which the patient has towards the therapist. And wherever there is transference can countertransference be far away? Under this idiosyncratic and enlarged meaning, “countertransference” becomes the therapist’s way of relating to the patient. For example, according to Paula Heiman, under this idiosyncratic interpretation of the relationship, “counter- transference” covers all the feelings the analyst experiences toward the patient (see Paula Heiman, 1950. On counter-transference. International Journal of Psycho-Analysis 31: 81 – 84). 

Of course, “counter transference” can mean an unprofessional or pathological response on the part of the therapist, as when s/he behaves in a moralizing, aggressive, or seductive manner; but it can also include appropriate and positive responses such as empathic ones. In the extreme, countertransference comes to mean empathy itself. Heimann’s  thesis is “that the analyst’s emotional response to his patient within the analytic situation represents one of the most important tools for his work. The analyst’s countertransference is an instrument of research into the patient’s unconscious” (1950: 81). The transference is not empathy, but the countertransference is essential input to the empathic process, even if not quite reducible to empathy itself.

While Freud innovated decisively in decoding the meaning of dreams in The Interpretation of Dreams (1900) and the exploration of infantile sexuality, from a clinical perspective, the elaboration of transference defined the clinical encounter between patient and therapist in the context of psychoanalysis. Transference becomes co-extensive with the encounter between patient and therapist. If you can’t form a transference, since the therapy consists in interpreting and raising the transference, the therapy is not going to work. 

We now turn from transference to empathy.

Freud explicitly states that unless the physician begins empathy in engaging in psychoanalysis, that physician is headed for trouble. The issue is that nearly no one knows that Freud said that because the Strachey’s mistranslate “empathy [Einfühlung]” as “sympathetic understanding.” I must insist on the point. We are on firm group as far as Freud’s guidance is concerned. “Empathy” and “sympathetic understanding” are not the same, and what is more, in a kind of Nachträglichkeit – or retrospective consideration – we lose the opportunity to connect to Freud’s guidance (see Agosta 2014). Thus, we have the kind of empathy wars that Heinz Kohut had to fight to demonstrate that empathy had a mutative effect on the structure of the self (presumably and especially including the ego). 

When Freud demonstrated by his empathic way of relating to the patient (including by his verbal interpretations) that he was not the authoritarian or seductive parental figure of the patient’s past or trauma, the patient would often resist, deny, or offer other defensive gestures against Freud’s interventions and interpretations. But eventually the evidence would add up. Freud was not the unkind parent or the seductive uncle – the mischief was coming from the patient’s unconscious (and his circumstances), not from Freud. With this realization, the patient was reliably able to shift out of stuckness and enjoy a new beginning in his work and romantic relatedness thanks to Freud’s revolutionary new method of treatment. 

Although there are numerous definitions of empathy, most include a narrow and an enlarged use of the term. In the narrow sense, empathy is a psychological mechanism, which, in folk psychology terms, as noted, consists in taking a walk in the other person’s shoes. It is rarely pointed out that one must take off one’s own shoes before putting on those of the other or one risks the distortion/defense of projection. As a psychological mechanism, Kohut defines empathy as vicarious introspection, though he does not merely define empathy in that way.

In an enlarged sense, empathy means being present with the other person without applying judgments, labels, or moralizing assessments. When I use the expression “empathic presence,” the word “presence” inevitably invokes Nacht (1962) and Nacht and Viderman (1960), who penetrating and insightful contribution should not be underestimated. However, as I use it the word “presence” should not be understood as a source or justification for any deviations in technique or the frame. If anything “presence” means “being with” one another in a Heideggerian sense or “being” in the sense of “going on being” as Winnicott employed the term. Even though not necessarily visible, if seated behind the couch, the analyst’s listening is a strong presence. 

If one understands “transference” in a broad sense of all aspects of relatedness to the patient, then it tends to merge with an understanding of “empathy” as the foundation of relatedness. 

Anything the analyst does to influence the transference is considered an issue – the question of the background to transference – passivity? Neutrality? Empathy? but empathy is the background to transference.

One of the most enlarged uses of the terms is to be found in Kohut. For Kohut empathy defines the entire field of therapeutic interrelations and one can even give a transcendental argument to that effect

Empathy is not just a useful way by which we have access to the inner life of man – the idea itself of an inner life of man, and thus of a psychology of complex mental states, is unthinkable without our ability to know via vicarious introspection – my explanation of empathy . . . what the inner life of man is, what we ourselves and what others think and feel. (1977: 306)

In this statement, empathy is the foundation of our relations to other individuals. This is a restatement and an expansion of Kohut’s celebrated statement in his 1959 article that empathy is the method of data gathering precisely about what other individuals feel and think. In turn, this method defines the scope and limits of psychoanalysis as a therapy and discipline. The field of empathy that of psychoanalytic therapy become co-extensive. 

As noted, one individual does not directly access the mental states of the other person, but rather had a vicarious experience of the other person’s experience. In empathy one is receptive to the micro-expressions of the other person’s experience – one has an “after image” and a “vicarious” experience of what the other is experience. 

The innovations continue. Kohut innovates around transference in 1971 – the establishment of what was first called idealizing transference and transference of the grandiose self and ultimately becomes selfobject transference is a distinct phase in the history of transference and tends to live like a split off bastion – for example, is there any evidence of a selfobject transference in the Wolfman, who had aspects of the depletion and grandiosity of narcissistic personality disorder? 

The selfobject represents the function that other people have for oneself. Kohut: “[. . .] [T]he general meaning of the term selfobject [is] as that dimension of our experience of another person that related to this person’s function in shoring up [supporting the homeostatis / equilibriating] our self [. . .]” (1984: 49)

In a standard relationship people interact in such a way that they mutually regulate one another’s thoughts, feelings, and actions. This is called “friendship.” It is also the give-and-take at the foundation of many forms of interpersonal cooperation, communication, and collaboration. When one’s spouse comes home from a hard day at the office or clinic or the backroom on Zoom and you give them a good listening as they vent the frustrations, double binds and bullying perpetrated by the boss or client, then you are functioning as a selfobject. Presumably such an interaction or function did not begin with Kohut’s coining the term “selfobject,” though it was more clearly delimited out of the undifferentiated background. 

One significant difference that, unfortunately, has resulted in controversy and lack of clarity, is how Kohut’s selfobject (narcissistic) transference is sustaining to the patient during the long process of interpreting, working through, and dissolving the transference and the inevitable transference distortions. Kohut took considerable pains to emphasize (and empathize!) that confrontational and moralizing methods would unleash reactive narcissistic rage on the part of the patient and that the empathic approach was critical path. 

This lines up with and is complementary to one of Freud’s early discoveries was a later version of this phenomenon – that what seemed to be a source of resistance was actually the way forward. However, the way forward means the possibility of relatedness between internal objects (everything from the superego to hostile introjects to good breasts) and the therapist. Key term: relatedness. Thus, when there are disruptions in the relatedness between the patient and therapist that is conceptualized as a breakdown in the transference – the loss of connectedness, even if the connectedness includes distortions, misunderstandings, and conflicts. But that is usually the way it is thought of or described in the context of classical analysis where the breakdown of the transference often results in what seem like moralistic or objective medical judgments that the patient is not analyzable. 

Instead, the relationship between transference and empathy comes into its own where, in the face of a breakdown in transference, empathy is used to restore the transference relationship. 

For example, speaking of a patient with significant narcissistic disequilibrium, Kohut writes:

  • When the narcissistic transference has become disrupted, he has the impression that he is not fully real, or at least that his emotions are dulled; he is doing his work without zest, that he seeks routines to carry him along since he appears to be lacking in initiative … ((1971): 16)

The restoration of the relatedness and the transference is brought forward when the therapist, using empathic understanding, shows the analysand that the therapist “gets” how the analysand is struggling with a setback or challenge in his life that he left him emotionally disequilibriated, anxious, lethargic, depleted. When this occurs repeatedly in the course of treatment, psychic structure is built and reinforced in the areas of emotional and behavioral regulation. A cure comes into view.

Kohut (1984: 66) writes: “[. . .] [The] aim and the result of the cure – is the opening of a path of empathy between self and selfobject, specifically, the establishment of empathic in-tuneness between self and selfobject on mature adult levels. [….] …the gradual acquisition of empathic contact with mature selfobjects is the essence of the psychoanalytic cure [. . .]” Of course, one must hasten to add that “empathic in-tuneness” is unlikely, even impossible, unless the distortions and illusions of the transference have been engaged interpretively (and in an empathic way) in course of making contact with mature selfobjects in empathic relatedness  

A number of issues occur here that clearly require further research and clarification of terminology. Why would selfobject transference be considered transference at all? Here “transference” again gets used in the broadest sense of “empathic relatedness.” It represents healthy relatedness, good listening, and interpersonal well-being. Interpretation of the transference is a key bridge between empathy and transference – when the interpretation is experienced as unempathic then the aggression released is not due to a lowering or elimination of defense against the death instinct but a reactive rage at getting one’s feelings hurt at being misunderstood by one’s therapist, being re-traumatized in the transference by unempathic caretakers or disappointed parental idealizations.

If such relatedness with its significant component of a “good listening” is spontaneously constellated in the psychoanalytic therapeutic encounter, then it may at first glance seem to be pure positive transference (the analyst as “good object”) or positive nontransference reality-based relatedness. Indeed, Winnicott’s transitional object is a special case of a selfobject but shows that the selfobject is a standard part of development in which the imaginary is integrated into the rich system of conventions and symbols known as everyday life. In that sense, the family pictures on one’s writing desk are reminders of why one works, making the absent present in what is literally a picture of health. 

Where transference was empathy shall be!

References

Szasz, Thomas. (1963). The concept of transference. International Journal of Psychoanalysis 44: 432 – 443. 

Stone, Leo. (1961). The Psychoanalytic Situation. New York: International Universities Press. [TI: 239]

Reich, Annie. (1966). Empathy and countertransference. In Annie Reich, Psychoanalytic Contributions. New York: IUP Press, 1973: 344 – 360.

Nacht, S. (1962). Empathy as a psychological mechanism and empathy as presence (of course it is both). Symposium The curative factors in psycho-analysis. II International Journal of Psychoanalysis 43: 206 – 211

Kohut, Heinz. (1984). How Does Analysis Cure? Eds. Paul Sepansky and Arnold Goldberg. Chicago: University of Chicago Press.

Kohut, Heinz. (1977). The Restoration of the Self. New York: International Universities Press.

Kohut, Heinz. (1971). The Analysis of the Self. New York: International Universities Press.

Grossman, Carl M. (1965). Transference, countertransference, and being in love. Psychoanalytic Quarterly 34: 249 – 256. 

Greenson, Ralph R. (1967). The Technique and Practice of Psychoanalysis vol 1. New York: International Universities Press.

Giovacchini, Peter L. (1965). Transference, incorporation and synthesis. International Journal of Psychoanalysis 46: 287 – 296. 

Agosta, Lou. (2014a). Rewriting empathy in Freud. A Rumor of Empathy: Rewriting Empathy in the Context of Philosophy. New York: Palgrave Macmillan: 66 – 82. DOI:10.1057/978113746534.0009.

(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.

Notes

[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 Limits of Empathy in Politics

If freedom of expression and free speech are flourishing, but no one is listening, then empathy becomes a tree that falls in the forest when no one is present. Empathy does not make a sound – or a difference. 

Even in politics empathy is always empathy. However, politics brings along a whole new set of questions, issues, and challenges by with which empathy is confronted and to which empathy gets applied. The political becomes personal, unsettlingly so at times.

What then is the limit of empathy in politics? This is the limit: the practice of empathy does not work well with bullies, sociopaths, psychopaths, QAnon style delusional thinkers, the criminally insane, and [some] autistic children. 

The prevalence of bullying in the school playground and politics is widespread and toxic; and one should never underestimate the power of empathy. Never. Yet, if your political opponent is behaving like a bully, empathy is not going to be enough. You will need to find supplementary methods – empathy alone will not work on her or him. These hard cases literally will not “get it.” They will not perceive the empathy. They will not experience your empathy. 

Worse yet, some bullies and psychopaths will accept your empathy and turn it against you, the better to control, manipulate, and dominate you. If the practice of empathy is not the way forward, how then does one deal with bullying without becoming a bully oneself?

The answer is direct: set limits. Set boundaries. Thus, far and no further! Stay in your own lane. Get back into your own corner. Stay in your own space. Keep your hands to yourself! In so far as empathy is all about firm yet flexible boundaries between the self and the other, a rigorous and critical empathy is engaged here; but until the boundary is reestablished, empathy cannot come into its own. Indeed once boundary violations occur and safety or security is at risk, the issue is no longer an empathic one – call for backup, implement self-defense measures, or escape and continue the struggle on another day.  

The FBI hostage negotiating team understands that empathy reduces rage and upset; and they use empathy in context for that purpose, though, as far as I know, they do not use the word “empathy” as such. Yet once the bullets start flying, the time for empathy has passed. Send in the swat team. For an illuminating article on the margins of empathy see Elizabeth Bernstein on “Advice From a Hostage Negotiator” (WSJ.com 06/14/2020) [https://on.wsj.com/3ajoYon]. Law enforcement gets empathy. Bad guys watch out. Once again, never underestimate the power of empathy. Never. 

In so far as empathy is all about respecting the boundaries between self and other, one group and another group, boundary setting is relevant to politics and empathy. So if one can reestablish a boundary, then empathy can be reintroduced, gradually, to guide us in how to cross back and forth across the boundary without submitting to bullying, provoking a temper tantrum, or getting stuck in breakdown. 

Yet the shadow of the tribalism falls over empathy in politics. Empathy gets a bad rap because empathy is often limited in contemporary political debates to empathy of identity. However, empathy – and that is the innovation here – empathy is also empathy of differences. Key terms: empathy of identity and empathy of difference.

With an empathy of differences, in addition to identity politics, we get a politics of recognition. 

Empathy shows up when one person encounters the other person and recognizes his or her differences. I hasten to add no one is asking anyone to give up or devalue his or her identity. The suggestion is that the Empathy of Differences lets identities flourish in a space of acceptance and toleration created by empathic recognition. The empathic recognition in turn creates a political arena where people can debate and compromise and get things done. 

Talking a walk in the other person’s shoes yields an empathy of differences. One discovers the otherness of the other. The shoe rarely fits exactly right. One discovers where the shoe pinches – but the other’s shoe almost inevitably pinches at a different spot when it pinches one’s own foot, because the other foot is slightly longer or shorter than one’s own. 

Though we are different, our interests, experiences, and aspirations as human beings are recognized.

Illustration of Republican presidential candidate Abraham Lincoln debating his opponent Steven Douglas in front of a crowd, circa 1858. (Kean Collection/Hulton Archive/Getty Images)

Our interests and aspirations have areas of overlap – for example, we want our children to flourish; we want to be able to make a contribution to the community; we want to be secure in our private lives and preference. With goals pursued along different paths, our possibilities converge or diverge without conflict. Our opportunities align in parallel or intersect at right angles instead of clashing. We are able to cooperate and embrace workability instead of obstructing one another. We are able to build instead of tear down. 

Once again, there is nothing wrong with the empathy of identity, but something is missing. What is missing is difference. The empathy of identity is ultimately that of proximity to family, tribe, and local community. As noted, there is nothing wrong with that. It is excellent. We would be less than human without it. But the empathy of identity is ultimately derivative and incomplete without an empathy of differences. 

If one is limited to an empathy of identity, the result is tribalism. “I get you, man, and you get me, bro, because we are alike.” No one is proposing to try completely to abolish tribalism, but tribalism is definitely limiting and constraining.

All these different tribes sets in motion a trend, which arguably is tribalism’s own undoing, dissolving its identity – Republicans, Democrats, Progressive, Conservatives, Libertarians, Christians, Muslims, Jews, Hindus, Buddhists, Confucians, Quakers, all 198 member nations of the United Nations – not to mention the Chicago Cubs Baseball team. So many identities – so many tribes. If one gets and belongs to enough of them, identity starts to dissolve. 

Tribalism itself sets in motion a dialectic whereby each individual can belong to multiple tribes with multiple identities and affiliations. If you participate in enough tribes and enough overlap between tribal identities, the notion of identity starts to dissolve into a kind of melting pot of multiculturalism, communalism, or ecumenical spirituality, market place of competing political ideologies. Even if the melting pot never completely melts, it can at least become a colloidal suspension – cosmopolitanism – where the identities and differences are fine-grained enough not to subvert individual diversity or the aspiration to commonly shared values. 

But absent such a dialectic of dissolution into a melting pot of identities– for example, in traditional societies or insular communities – the empathy within the communal group works well but breaks down at the boundary at which one encounter the other individual and group and their differences.

The innovative point here – to emphasize once again – is that empathy is about identity and similarity, but it is just as importantly about differences. 

Speaking in the first person, when I encounter an individual who is different than I am, then I have an experience of otherness. However, every person I encounter, without exception, is different than I am, even if there are similarities. The other is different than I am. But without the other individual there is no empathy. Empathy is born in otherness. Empathy is born in the difference. Empathy is born in the difference of otherness and in the otherness of difference. 

If that starts to spin, enjoy the ride.  At least you are not alone – as the practice of empathy is the one thing you cannot do all by yourself. Empathy is a function of otherness. Without the other individual, there is only myself – oneself. 

Solipsism is the philosophical position – the illusion – there the entire universe consists of oneself very alone – hence, solus ipse. One is the creator of one’s entire universe – life is literally but a dream – until one encounters the other – then one wakes up to the reality of the resistance of the other – and the resistance of the other emerges from differences – the otherness of the other. You need an other – and the other individual’s differences – to get empathy started. 

Being open to the other person’s feelings, affects, experiences, beliefs, and resonating in tune with the other individual, yields inevitably both the similarity and differences of those feelings, affects, experiences, and beliefs. That is the empathic moment: I realize we are different and that difference lives and becomes accessible in the space of acceptance and toleration between us. 

This brings us again to the limit of empathy in politics. Thus, the fundamental political question for a rigorous and critical empathy in politics is what to do politically with individuals and groups that one cannot stand. 

What to do with individuals and groups who arouse a visceral dislike and antipathy that are acknowledged to be irrational? What to do with individuals and groups with whom one disagrees on policy, practices, perspectives, procedures, customs, or spiritual practices? The tribalism of the empathy of identity is not going to get you of this impasse. 

The reduction to absurdity of the empathy of identity is humorist Tom Lehrer’s satirical song,  “National Brotherhood Week”:  “Shake the hand of someone you can’t stand.” 

Humor and empathy are closely related. One crosses a boundary between self and other in both cases. In humor one crosses the boundary with aggressive or sexual innuendo; in empathy one crosses the boundary with gracious permission and generosity. 

Lehrer predictably succeeds in being wickedly funny, though deeply cynical, as he sings an upbeat tune: “…The rich folks hate the poor folks and the poor folks hate the rich folks. All of my folks hate all of your folks – it’s American as apple pie! But during National Brotherhood Week – Sheriff Clarke and Lena Horne are dancing cheek-to-cheek.” Note that Clarke was a notoriously committed racist and segregationist during the early Civil Rights struggle of the 1960s and Lena Horne was a celebrated African-American singer of romantic smoky ballads – not a likely match up on anyone’s dating site.

While shaking the hand of one’s sworn opponent (or an elbow bump in a pandemic) is always a good start, it is ultimately incomplete. Unless an empathic context of toleration and acceptance is established for the hand shaking, the risk of shaking hands with someone you can’t stand is that one will end up despising the other even more. 

Lehrer’s song ends by expressing the unexpressed elephant in the room “…[Be] nice to people who are inferior to you / It’s only for a week so have no fear / Be grateful that it doesn’t last all year.” 

As the song implies, absent additional training in and work on empathy and critical thinking, the hypocrisy and prejudice live on. The practice of empathy becomes the practice of a rigorous and critical empathy. 

The disciplined practice of a rigorous and critical empathy is on the path to well functioning political community and successful engagement with one’s political opponents and rivals. A rigorous practice of empathy requires critical thinking to guide it, and, in turn, critical thinking requires empathy to open the space of relatedness, acceptance, and toleration of differences. 

This rigorous and critical empathy includes critical thinking. Critical thinking includes such skills as questioning in the sources of one’s facts and beliefs, examining and questioning one’s assumptions, assessing conflicting reports in the media, looking for hidden assumptions and biases, examining one’s own for conflicts of interest, recognizing one’s own mistakes and cleaning them up at once, basic listening skills, taking turns, and seeing if one’s conclusions are actually implied by one’s facts and reasoning from these facts. These are all important. But the number one skill of critical thinking is putting oneself in the place of one’s opponent, competitor, or colleague and considering the alternative point of view – cognitive empathy. Such empathy becomes a priority in a political context.

In conclusion, when empathy becomes a rigorous and critical empathy, then the limits of empathy in politics are the limits of politics, not the limits of empathy.

References

Tom Lehrer, National Brotherhood Week [performed]: https://www.youtube.com/watch?v=aIlJ8ZCs4jY

© Lou Agosta, PhD and the Chicago Empathy Project