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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
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.