This is a transcript of the talk.

The recommendation? Listen to the podcast: https://anchor.fm/lou-agosta-phd/episodes/Empathy-and-LIterature-Grand-Rounds-Presentation-at-Rush-Medical-University-October-13–2016-e177nvv

or watch the Youtube video: https://youtu.be/sYJvplP5cKo

Howard Kravitz, MD: Welcome to the partner psychiatry gran realms this morning is my pleasure to introduce the speaker dr. Lou Agosta got his PhD in philosophy at the University of Chicago with a dissertation entitled empathy and interpretation and running with that as his career scholarly activity ever since he’s an assistant professor of psychology at the Illinois School of Professional Psychology and Argosy University and instructor of philosophy at the University to call the Graham School of adult education and director of research at other gang psychotherapy services in Chicago he also as a psychotherapy practice in the Chicago community who specializes in making empathy present in his storytelling and listening – he’s committed to a gracious and generous listening based on empathy which I personally experienced a meeting with him this summer to talk about his idea for Grand Rounds – as an educator he teaches empathy in the history of and systems of psychology program at the Illinois School of Professional Psychology and Argosy University – he has published three scholarly academic books on empathy entitled – empathy in the context of philosophy – a rumor of empathy: rewriting empathy in the context of philosophy – and a rumor of empathy: narrative and recovery – he also undertook training as a psychodynamic therapist at the Chicago Institute for Psychoanalysis – however did not complete the program when he was summarily dismissed for asking publicly “is anyone beside me aware of a lack of empathy?” – so with that I will turn the program over to him

Lou Agosta [LA]: Well thank you so much dr. Kravitz for that introduction – so the challenge is to make empathy present – will we be able to do that in the next 45 or 50 minutes? I begin by acknowledging your empathy – you all are going to be doing some listening and I appreciate that and recognize that and acknowledge it – and I want to be concise and allow time for questions in interaction at the back end – some logistics and housekeeping make sure you have the color handout – if you don’t it’s in the back on the left side – there it says how empathy functions – 2-sided copying ladies and gentlemen – and then how empathy breaks down – so sometimes we can create a breakthrough based on a break down – and one of the results of the conversation that we’re going to have today among others is a short history of the distinction empathy – in fact the secret underground history of empathy – we’re going to define empathy –

Lou Agosta [LA]: we’re going to look at some examples of empathy through literature – so rather than clinical examples I’m going to ask you to take it up a level – the guidance is and with all due respect don’t be too concrete don’t be too literal let’s get our metaphorical transference thinking caps on and look at empathy of [in] some examples of world literature and then I’m going to make time – I’m going to say a few things about how empathy is teachable trainable – in fact that’s so important i am going to give you the answer right up front – basically people are naturally empathic – if we remove the obstacles to empathy, then empathy shows up – in other words, the obstacles to empathy are the such things as: denial, resistance, cynicism, bullying, aggression, bad language –

LA: I have a great Dilbert cartoon here -[make sure you] don’t get inside of a Dilbert cartoon – [it is] hilariously funny – closely related to empathy – [drive out] denial, cynicism, guilt, shame, and the like – remove the obstacles to empathy and it [empathy] naturally comes forth – so that’s the answer – what’s the question? – how do we train everyone ? – so we’re gonna circle around and return to this at the back end – we’re going to begin with a short secret underground history of empathy – so this is going to be blazingly concise –

LA: this is the part which you may find somewhat academic [but important] and there as you look at it in the upper left hand corner a man named David Hume [ who published] A treatise of human nature 1739 – [in the year] 1739 the word empathy in the English language was not even invented [it was not invented] until 1895 when a Cornell University psychologist – a man named Edward Bradford Titchenner was translating some of the works of Vilhelm Vundt [Wilhem Wundt] – I have to get my best German accent on there – it comes across as empathy – he [Titchener] makes up the word [empathy] – okay – meanwhile […] that’s why we have a secret underground history of empathy – Hume is writing and has at least five different definitions of sympathy – I say close enough – you have the hand out – the complete deck is on the URL on the lower left hand corner [see the youtube video for the slides] – I’m not going to speak slowly enough for you to take notes –

I’m going to tell you what the five different definitions of sympathy – they’re there and you can go back and get them – he never a stickler for consistency – the philosopher Hume divides sympathy as (1) emotional contagion – he defines sympathy as (2) suggestibility – the power of suggestion – (3) he defines it in a somewhat technical way as a double representation of a vicarious experience of another person combined with the idea of the other that matches closely to a modern definition of empathy that we find in psychology (4) he also defines sympathy as a delicacy of sympathy and taste and this matter of substituting a certain kind of sympathy in the experience of the work of art – this is the secret underground history of empathy – we relate to other people on a good day as if they were works of art – that is without use value – without manipulation – without knowing something – without categories – without argument – and [on] a less good day we struggle like everybody else – and finally as (5) benevolence – he defines sympathy as compassion or benevolence –

LA: and so we’ve got all these definitions – what the heck is it [empathy] – what is this definition so I sent the class [I was teaching at the time] out [to do research by asking people on the street] – I have everybody in the class – several classes – each student asked five people what they think empathy is – not members of your family people – you know moderately well – not really close – you know – but people you might work with or run across at the club or at the gym or something – so there’s a trend – so sometimes I go around saying we don’t need more Data we need expanded empathy – I’ve been known to say that – and nevertheless we need both data and empathy […] -I say more empathy – it’s like there’s something missing rather than something wrong – let’s expand – the languaging is significant as well – this is in the realm of tips and techniques- okay – so anyway – so the people go out and ask them and so here’s the trend: most people think empathy is something like compassion – they tell the story about altruism – they tell a story about charity – they tell the story about doing good – they tell the story about making difference – they tell a story about being nice and heavens knows ladies and gentlemen, the world needs more niceness – [yet niceness] it is distinct from empathy – we’re going to say a little bit more about that but first I want to very concisely touch on – as you look at the picture in the upper right hand corner – Immanuel Kant – he died in 1804 – he had the distinction between putting oneself in the position of the other person – he said enlarged thinking – think as the other [people] think and feel – so that’s top down – in effect we take that as the folk psychology definition of empathy – we take a walk in the other person’s shoes – where does the shoe pinch – where does the moccasin chafe – and then he also he once again interestingly and controversial enough in the context of a theory of art and beautiful nature he talks about the communicability of feeling – art is impossible without the communicability of affect – feeling – that’s stage one of empathy – now if you stop, [then] there you get emotional contagion – you get suggestibility – you get a certain kind of shared mutual enthusiasm – and there’s nothing wrong with that if there’s further processing upstream and downstream that’s going to occur – nevertheless it’s right there and then [we are going] around the circle –

LA: and this is why this is the secret underground history: on the bottom left – a man named Theodore Lipps – remember the movie Amadeus ?where you know Mozart is slaving away and the most famous man of his day a musician named is Antonio Salieri who today except for the movie Amadeus nobody would have ever heard of Antonio Salieri – I mean he’s not played – or they’ll give attention occasionally now because of the movie – right – and today Mozart – everybody knows Mozart’s music is played widely and nobody’s ever heard of Salieri until you come across the movie – well Lipps is Salieri to Freud’s Mozart – Lipps wrote several volumes in which he gives currency in the German language to the word Einfühlung [empathy] – he [Lipps] in effect replaces the distinction aesthetic taste judgment of a feeling of pleasure or displeasure with Einfühlung [empathy] – and he [Lipps] is significant because seven volumes of Lipps work are in the Freud Library – Freud encountered empathy by reading Theodore Lipps –

and [Freud] footnotes Lipps explicitly in Freud’s works on jokes and the relation to the unconscious – and the number of his aesthetic works – so moving right along there are twenty-two mentions of empathy in 24 volumes of the Freud Library as Harry Trosman MD and Simmons – our colleagues over at the analytic Institute – have done the scholarly work – here’s the point – almost every one of them [references to empathy] is mistranslated – freud says in so many words in his 1913 [year published] recommendations for physicians beginning psycho analytic treatment: you will go wrong if you begin with any other method besides empathy – quote end quote – it’s there and that gets mistranslated as sympathetic understanding – the Strachies [translators] will have a few other devaluing things to say about the word empathy so that’s the secret […] – the rest is history which we’re not going to do in the necessary detail – we’re going to move right along –

so most people think that empathy is compassion – and heavens knows the world needs more compassion – yet [compassion] it is not empathy – so what then is it ? Well basically we’re gonna have about two or three different definitions but the main definition which you have in front of you is to the effect – I know what the other person is experiencing because I experienced it also – not as a merger but as a vicarious experience – note vicarious experience contains the word Vicar which means representative – the etymology right as it actually works in this case if that is the the bishops representative to the community – the Vicar of something or other – and in any case combined with the distinction Other – and so basically here’s the distinction – empathy tells me what the other person is experiencing – and my good upbringing, my morals, my values, tell me what to do about it – and so that’s the compassion part – it’s in and its distinct – so having said that now here’s the most controversial slide I want you to pick up on this because it could be a controversial –

and I want – to quote to Jodi Halpern and I’m gonna wave Jodi’s book at you [entitled From detached concern to empathy: humanizing medical practice – Jodi Halperin – this is [published] 2001 so this has been around for a while and you know if we’re gonna have lunch afterwards – if you want to take a picture of the cover – I’ll bring it [the book] along with me and you can check it out but basically she says – the field of medicine empathy is a mode of understanding that specifically involves emotional resonance so it’s not just top down – it’s also bottom up – I’m getting some kind of a vicarious experience – this may or may not be the case – this may or may not be the case […] and so you know nevertheless she puts a stake in the ground and she is actually a psychiatrist – she has some stories

and I turn now to the explicit definition of empathy which we’re going to work with here and there are four phases to it – and that’s the handout – […] you get the handout – it’s on the left there – in the back table – so you want to be on the side: how empathy functions – […] so we’re gonna go around in a circle – we’re gonna go around in the circle here that would be actually counterclockwise – I’m open to the other person – I’m receptive – I have mirror neurons – and here’s where one can insert the underlying physiology – the underlying neurology – that’s not visible – here us mammals – we seem to resonate together – something is going on – we’re attached – it’s a myth that we aren’t related – we are related – physiologic\ally, biologicall,y and so [that is] phase one […]

phase two that creates a potential space for interaction – what’s possible in the relationship – do I relate to the other person as a means or end – do I relate to the other person as a possibility as a potentiality – we’re going to see an example of that and then actually you have to jump across so that gives us empathic receptivity- empathic understanding and empathic interpretation is the third aspect of empathy and that is the folk psychology of empathy – I take a walk in the other person’s shoes – I imaginatively change places with you – now that’s easier said than done because I don’t know you and nine times out of ten if I don’t, [then] I’m going to attribute to you aspects of my own character traits – Who I am – what I’m up to and that’s the challenge – right? – that’s not going to be and it’s going to be a psychological mechanism called projection which has its uses and is of interest – nevertheless is once again not empathy – and so get a view from over there but that does especially when I come up short I don’t know who you are – where you came from – then I go to the cognitive imaginative projection – and that’s very useful – and finally empathy can be a tree that falls in the forest without anybody being there – does it make a sound? does it make a difference? I have to say something I have to do something – a gesture- an aspect of behavior to let the other person know whether or not I have gotten what their experience is and sometimes that’s called empathic listening – that’ll work – good gracious listening – that maybe it is self sufficient but sometimes it’s not especially if I don’t know the other person – it may we’re highly verbal – you know there’s a lot of words and sometimes it’s necessary for me and so empathic responsiveness – so we’ve got receptivity – understanding – interpretation – and responsiveness –

I take the other person’s experience and give it back to them in such a way in such a form that the other person recognizes the experience as their own – on a good day that’s how it works – that’s the aha moment – that’s what I was going through – it’s sometimes it could be the very words but often it’s not – often it’s I’ve got inside the movie of your life for a little while – now each of these [four moments of empathy] breaks down in an interesting way and we’re going to therefore look at the breakdown – so this summarizes something interesting and which I think I do want to say it’s always useful to know the order in which one has one slides but basically this is the matter of so we’re gonna, you know, this [talk] is front end loaded – I acknowledge this presentation is somewhat front and loaded because there are several important ideas I want to get into the space and on the table so that we can mix it up about it – but basically so this is the compassion fatigue the burn out moment – heavens knows, occupational hazards – professional challenges – if I may say so – here’s the guidance – this may be for the easier said than done but nevertheless it must both be said and done – and insofar as humanly possible: if I’m interacting with somebody who is suffering, it is highly probable that I am going to suffer – the recommendation, the guidance is, that I have a vicarious experience of that suffering – if I am suffering in such a way that I am in breakdown or upset, [then] I’m doing it wrong

That’s the easier said than done – if I’m overwhelmed by the suffering – as strange as it may say sound to say: I should suffer but not too much – and so this points to the matter of a granularity – to the receptivity – there’s a filter there – right – I mean this all hypothetical – interesting to engage – nevertheless I may want to make the filter more granular and do things to take a little distance so it is not an on/off switch – the takeaway here – not an on/off switch – more like a rheostat – more like a dimmer on a light switch and this is where training and practice make the difference – so I mean we may or may not come back to that – but I want that [statement] in the space so that we can work with it as we get to these examples we’re going to look at – so am I going in the right direction here […] I see we’re just on time –

we look at three or four examples – here I may cut this short because I want to say a little bit more about the training aspect but we’re going to look at Thomas Mass – Thomas Mann is a storyteller – this story got told on or about the year 1900 – it’s about a family the name of Buddenbrooks – they’re a business family – right – and the context is Thomas Buddenbrooks – so here’s the inside skinny – here’s the Birdseye low down on this Buddenbrooks caper – Thomas Buddenbrooks is an artistic type – he’s very artistic – and his father passes away in an untimely way and he – Thomas – goes into the family business to pay the bills – you know, one can understand why one would do this – he gives up his artistic career – his artistic aspirations – and instead of pursuing an artistic career, he marries one – her name is Gerda – she’s an artistic type – we’ll see a picture of her later – […] – she’s playing the violin – she’s a virtuoso violinist – playing passionate virtuoso violin duos with her talented father – it’s so great to have a great relationship […] it’s a very good thing and they have a son – Johann – Hanno, for short – he’s an artistic type – he’s portrayed by Mann as being on sickly – I mean, he’s got bad teeth – this is going to be an issue because this is 1900 – you know dental science – oh my god this has to be interesting –

LA: [ …] some people are already squirming in their seats – it’s working – the mirror neurons are going off even if they don’t exist – this might be a good point to digress – the myth of mirror neurons – professor – C[Jean] Decety – he’s got the MRI machine down at Gates Blake – he recommended this book by Gregory Hitchcock- there’s an underlying neurological mechanism, ladies and gentlemen – it does [or doesn’t] have to be mirror neurons – how about Association? – have you considered a good old-fashioned association? – there’s some implementation mechanism – it’s highly interesting and controversial – I’ll keep the book handy – it’s a scholarly academic debunking […] but what isn’t debunked is our physiological relatedness – even if they [mirror neurons] don’t exist, we’re physiologically related – that’s interesting so and not in the way you might have thought – okay – so anyway you know the dentist – we’re gonna have a trip to the dentist here thanks to Thomas Mass and I’m actually going to read it to you – the paragraph long quotation – so Hanno has bad teeth – in Mann bad teeth are a sign of artistic sensibility – in the case of Hanno he’s kind of sickly – kind of small – he gets bullied by the straggling Nordic types down at school – you know they push him around – it’s not a pretty picture – and his father becomes [a book camp dad] [the father, Thomas] he’s kind of badly compensated – I would say and he’s this hail-fellow-well-met – my son – give me your mathematical multiplication tables – and Hanno knows his tables – he just can’t perform – he breaks down – it’s pathetic – you know but he’s like seven years old – wa, was [crying sounds] – buck up my son – Thomas is boot camp dad and it’s not working – okay – so meanwhile there’s a bit of orality – you know, we can do the oral symbolism – Hanno needs to vigorously suck on the nipple of life and he’s really struggling to engage

[Meanwhile] – off to the dentist doctor – the dentist is already upon dr. brecht – a pun – it’s broken – so I’m gonna read you this slowly –

‘The bad thing about Dr. Brecht was he was nervous and dreaded the tortures he was obliged to inflict – we must proceed to extraction – he would say growing pale – Hanno himself was in a pale cold sweat with staring eyes incapable of protesting or running away – in short, in much the same condition as a condemned criminal – he saw dr brecht’s sleeve and the forceps bending over him and noticed that little beads were standing out on his bald brow and that his mouth was twisted – when it was all over and Hanno, pale and trembling, spat blood into the blue basin at his side dr brecht had to sit down and wipe his forehead and take a drink of water”

LA: So what’s going on here is a breakdown – this is a breakdown in dr. Brecht’s empathic receptivity – he’s overly empathic – one might argue – compare and contrast – the description itself gives us access to the phenomenon – right – both both are sweating – brecht’s mouth is twisted – interesting, the mirror neurons are going off – [brecht’s] his mouth is twisted [so the mirror neurons are going off] – so what’s the recommendation? this is the time for a bad joke – right – he should have gone into ophthalmology – forgive me – okay so back that one out – okay pause for laugh – but anyway it’s a serious insignificant group here – so here’s the breakdown and so what’s the recommendation? – given that empathic receptivity is breaking down on the part of dr. brecht […] – to get some distance from the tortures he inflates – given what is 1900 Dental Science – oh my god – it’s hard to think right and so he has to increase the granularity of the filter – easier said than done but practice practice practice practice what does that look like because he’s providing a useful service – […] I mean, it’s like it’s misery – there’s all kinds of mystery – okay – so you know I pause for breath at this at this point – I would ever take questions even at this point about the example – you know it’s not like this is a quiz and I don’t you know you’re eager for me to move along but don’t be shy raise your hand – okay, so we will move to the next example and that if you think of anything we can circle back around – so remember the set up – Thomas Buddenbrooks gives up his artistic career and he marries someone who is very artistic – Gerda – and she is artistic and she has to move and locate because the Buddenbrookss live in a different town than her father – so she’s no longer playing violin duo’s with her father – she’s got nobody to play with – one might say – so she meets this lieutenant who happens to be a talented violinist in addition to his military aspirations – so they’re upstairs playing passionate violin duo’s and Thomas’s office is downstairs and he’s listening to the violin music – and that’s not the problem – there’s nothing wrong with that – then the music stops – then there’s silence – there’s more silence – there’s even more silence – Thomas is going crazy – Is he going to become the caricature of a jealous husband? – that would be to throw the guy [lieutenant] out – that would be a scandal – that would indeed be a caricature – right – so he’s wandering around pacing back and forth – so he is pacing back and forth and he runs into Hanno in the hallway next quotation –

“His father did not seem to be listening – he held Hannes free hand and played with it absently, consciously fingering the slim fingers and then Hanno heard something that had nothing to do with the lesson at all – his father’s voice in a tone he had never heard before – low distressed almost imploring – Hanno, the lieutenant has been more than two hours with Mama – little Hanno opened wide his golden brown eyes at the sound and they looked as never before clear large and loving straight into his father’s face with his red and eyelids under the light brows its white puffy cheeks and long stiff moustaches – God knows how much he understood – but one thing they both felt in the long second when their eyes met – all constrained coldness in this understanding melted away – Hanno might fail his father in all that demanded vitality energy and strength but where fear and suffering were in question, there they were as one empathic understanding –

Hanno [saw] something that he had not previously perceived – this father was boot camp dad – multiplication tables right – the time goes by – Oh God now he sees – so what’s the word? vulnerability – that’s one possible description – this bootcamp dad is vulnerable – he’s suffering- Hanno does not get it – what does it mean – playing violin duos and then silence -Hanno’s seven or eight years old – right? – so their eyes meet – that is the moment of empathic receptivity embedded in empathic understanding – the father who was so inaccessible in his hail-fellow-well-met and boot camp-style cross-examination of Hanno about his lessons becomes vulnerable and accessible in his suffering – Hanno gets it – his father’s suffering is a possibility – the possibility of his humanity – they share a human moment – the possibility of relatedness emerges in which both are human beings and an emotional connection with one another – this had not been available to Hanno before – for whom his father was this strong demanding taskmaster – now he sees his father’s vulnerability and it humanizes both of them – this is also an example of empathic understanding that works to an extent but ultimately the father remains [in] the role and the story goes along […] What you want to get here is just a picture of the lieutenant and Gerda – they are practicing the violin – she’s giving a master class in practicing the violin – and so let’s do a reality check here – I want to leave both enough time for questions and answers and say something about a little bit more about training

So I’m going to fast-forward through interpretation – if you get the deck you can get some detail and move on to the Glass Menagerie [by] Tennessee Williams who is a formidable psychologist – so the story in brief: Amanda is the mom – Laura is the frail, fragile keeper of The Glass Menagerie – she lives in the back room – she is the daughter – she has a brother, Tom, who has a friend, Jim – Amanda, the mother, had many gentleman callers in her youth – she was popular – we could do with the song from Wicked [the broadway play] at this point but perhaps we won’t – we can we splice that in later – but as she was popular – now she’s fading – the bloom is off the rose – off the flower in the years nineteen fifties – and she so badly wants a date for Laura – to get a date – she wants her to have a gentleman caller caller so she pressures her son, Laura’s brother, Tom, to bring somebody from down at the factory and finally Tom invites Jim, his friend – there’s other information asymmetries in the story – Jim’s already engaged – get ready – you don’t necessarily know that at this point [in the story] but look is to follow along so the invitation is accepted – at last a gentleman caller! – the problem is Jim thinks it’s just a casual dinner with his friend Tom but in fact he then meets Laura who know Jim from grammar school – they went to grammar school together! – it’s small world and Jim sees her and and he says two words: blue roses – blue roses – and Laura is taken aback – she had many childhood illnesses including pleurisy – fluorosis – and when the teacher this was the day when the teacher would say why you weren’t in school well she’s got fluorosis or pleurisy – nobody knew what that meant anyway but Jim hears that as “blue roses” so here’s the part we’ll cut to the chase – Laura also has another childhood disease which leaves one of her legs slightly shorter than the other – polio- and as she walks down the aisle her experience of herself as that she’s making this enormous clomp clomp thumb clomp clomp as she walks down the aisle that everybody must know about it –

of course Jim didn’t even perceive it [it is so soft] and so we have here an example of what amounts to empathic responsiveness – he [Jim] gives her back his experience of who she is for him – for Jim, Laura is “blue roses” – something beautiful even if kind of melancholy – she’s got this melancholy aspect to her which makes her all the more attractive of course – […] and whereas she experienced herself as clunk clunk clunk thunk – the asymmetry there is very powerful – it’s very nice – I think Williams is a brilliant psychologist – I mean – and unfortunately – I mean – he’s also pretty depressed himself and it ends badly – nevertheless we’re going to enjoy the moment – the emotional devastation [is powerful art] – okay, so having so you know that’s three out of four examples – now we’re just on time

I’m going to talk and to tell you about an exercise rather than do the exercise – I call this exercise: I can’t hear you because my opinion of what you are saying is so loud – I’m going to be disarmingly with candid – so you know there I am walking down the street – and I am ashamed of myself – the author of three books on empathy – [and i am thinking devaluing thoughts] – how did that person get to be that way – I’m judging and evaluating – there’s these thoughts – what happened to you man? – wherever it comes, from it’s not authentically Who I am – you want to take this and apply it as appropriate and to yourself: there I can’t hear you because the opinion of what you are saying is so loud in my own thinking – so this is an exercise, not how to listen better, but how to expand one’s listening – right – stop and so actually this is where the the [Dilbert] cartoon comes in handy –

[…] there’s an exercise here that this is how to train for empathy – what does it mean to train empathy – remove the obstacles such as cynicism, categorizing people, labeling, pigeon holing, and so on – I’ll read this to you just so some of you are picking up on it – [in the Dilbert cartoon]: now so there’s the pointy headed boss [and he says] “from now on all teams will be formed on the basis of myers-briggs personality test types” “if you do not have a personality, one will be assigned to you by Human Resources [dept]” – okay, laughter at this point, [this] is deeply cynical […] this is what not to do – right? – and then the final [statement of the cartoon] “we need a quiet dumb guy to pair with an extroverted thinker” – well here the cynicism is what gets in the way of empathy – now that is not to say that it is not abroad in the land of the corporation [and it] goes off the rails – so what I invite – what the exercise consists of doing is going inward and realizing that if one goes inward far enough, one encounters the other – so we actually are going to take literally a half a minute and do the exercise –

So I’m going to ask you to be quiet and listen to yourself […] now there may be papers going off so just include that because this is after all a hospital – […] but listen to what is there – okay are you ready – any questions before they do the exercise? – it is it clear what I’m asking you to do ? please say if it’s not clear […] so you’re just gonna listen to whatever is there okay ready set go

[pause for thirty seconds]

Okay – that’s 30 seconds […] now you might have heard something like “what is he talking about?” “where did this guy come from?” “What voice?” “What conversation?” That’s the one – that’s the one [we are talking about]! – it’s not who I authentically am – and [yet] that is a source of empathic understanding -I am in relationship with the other and I’m going to have judgments, opinions, evaluations, philosophical arguments, categorizations, labels and so on – there isn’t anything wrong with those – those thoughts occur – they are inevitable – you can’t – ladies and gentlemen, you can’t stop thinking those – you can’t prevent it – what you want to do is get some distance from it and realize when it’s useful and when it’s less useful and so with that said we’re going to have some time for questions –

The one final thought I leave you with – and it’s a direct consequence of this little exercise – to listen to oneself, when all the labels are removed, when all the categories are removed, when all the philosophical arguments are removed, when all the cynicism, hostility, affectation, even compassion, sadness, fear, guilt, shame – when all these things are removed, [then] empathy consists in being in the presence of another human being

LA: what are your questions?

LA: The lady in the back – I’ll repeat the question – go ahead –

Do you think you can teach empathy?

LA: The short answer is yes […] so I’m going to repeat the answer – I just [asserted] we’re naturally empathic – remove the cynicism, denial, shame, guilt, and empathy naturally shows up – train the trainer now that’s not considered the possibility […] there other tips and techniques – this is the realm of tips and techniques: my reaction to you tells me something about both of us and a lot about myself which I then parlay forward to understand the relationship

[….] The challenge to create a context in which empathy can show up – right that’s not a trivial things – it’s a lot of work – and of course teaching is information transfer – I put information in your bucket – you bring a bucket or a basket and the teacher puts information in it – there’s nothing wrong with that – we need that – […] the world doesn’t work without information and there’s also the other aspects – dimensions – especially to our humanity and what happens in the context of a conversation – so you know there’s some work to be done on creating [possibility] and that’s what I think [why] literature has its uses in creating a context for a conversation that’s why I find it useful other questions? so I mean feel free to challenme

Individuals have been in some tough spots in the trenches for a while and become hardened – I think you use that word and how does one recover from that? – so I would also put on the list compassion fatigue – burnout – this is a significant occupational hazard – I mean – take some time off for self-care – this is the case for self-care – that one has to find some things where one can restore one’s emotional energies if you will – that we have something like emotional energy – and because being burned out – being compassion fatigued – I ain’t doing nobody any good much less myself – right? – so sometimes one has to get some supervision – I mean now leaving aside matters of such as vacation and that is where I find humor which is closely related to empathy – this Dilbert is deeply cynical right? – but –

in both empathy and humor one traverses a boundary – in the case of humor, one can say look at the boss is an idiot and it’s funny – Human Resources says a personality will be assigned to you – it’s hilarious, right? […] it’s the reduction to absurdly right? – so philosophically, it’s a reduction to absurdity – so one can use humor […] so this is the case for one’s own psychotherapy – I mean that the therapist him or herself may usefully encounter at some point in their development something like whatever this thing is – therapy h- aving a conversation with oneself – journaling – it may become a self-sustaining process – I get a lot out of journaling – I mean some people do and some people don’t – the world is not generous in the matter of certain things such as empathy – put it on the list with compassion as well right? – and so one has to find some resources to recharge one’s empathy – oftentimes it’s family – speaking personally, coming up, I experienced the lack of empathy so I actually started writing about it – and that was how I approached it and I kind of symbolically created something for myself […] – one final question…

LA: we are out of time – one final question?

what is the triad that sustains the therapeutic process? Warmth, accessibility, what else?

LA: okay well the concise answer is the Triad is – empathy empathy and empathy and warm and accessible is also useful – on a good day the other individual will show you who she or he is – if I am present without categories, distinctions, labels – on a good day they’ll reveal their soul – on a less good day we will struggle like everyone else – thank you so much

I heard there was some lunch – I don’t know if there is – I heard it was are up on six – I’m gonna go up there and check it out

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

Empathy is never needed more than when it seems there is no time for it. Empathy is never needed more than when it seems the budget does not allow for it. Empathy is never needed more than when the cynicism and resignation about life, whether in the family or the corporate jungle, are so thick you can’t catch your breath. 

Being ready for empathy is like being ready to be born. No one is ready to be born. You just get born. Ready or not, the individual is thrown into the world. No one asked you if you wanted a life. You just got one. 

Empathy enables you to have a human existence filled with satisfying, engaging, dynamic, fulfilling relationships instead of living in an empty,  depopulated emotional desert. 

There is enough empathy to go around. The key to the empathy readiness assessment is realizing enough empathy is available for everyone. Empathy is not a zero sum game. There do not have to be losers versus winners. If you can get your head around the idea that there is enough empathy available in the world—crazy as that idea may seem at first—then you are ready to engage with expanding empathy in your life and the community.

Seems impossible? Let us take a step back. You know how we can feed everyone on the planet, so that there should be no need for people to get sick and die of starvation? Thanks to the “Green Revolution,” high tech seeds, and the economies of scale of agri-business, enough food exists to feed everyone. Yet people are starving. People are starving in the Middle East, Africa, and in parts of the USA. People are starving because of politics in the pejorative sense, breakdowns in social justice, violence, aggression, bullying, cynicism, bias, prejudice, fragmentation of communities, and human badness. There is enough food to feed everyone, but it is badly distributed. 

Likewise, with empathy. Enough empathy is available to go around; but it is not evenly distributed. People are living and working in empathy deserts. 

Organizational politics in the pejorative sense of the words, attempts to control and dominate, egocentrism and narcissism, out-and-out aggression and greed, stress and burnout, all result in empathy deserts. Empathy gets hoarded, creating empathy deserts locally, even amid an abundant ability to practice empathy.

Create a clearing for success in working on expanding your empathy, contributing to growing empathy in yourself, other individuals, and the community. Perform a readiness assessment for empathy training

Therefore, this guide to bringing forth a rigorous and critical empathy training does not call for “more” empathy, but rather for “expanded” empathy. The difference is subtle. Commenting “We need more empathy here!” implies the individual is unempathic—are you saying I lack empathy!?—and that is an insult, a dignity violation, a narcissistic injury, creating even more conflict and shrinking empathy. 

The way we put our words together makes a profound difference. Experience indicates the call for “more empathy” results in a further breakdown of empathy. In contrast, calling for “expanded empathy” makes a difference in getting unstuck from difficult, sticky situations, reestablishing relatedness, de-escalating conflict, interrupting anger or soothing rage, shifting out of upset, and overcoming the challenges of relating in a world that can from time-to-time be decidedly unempathic. 

In extreme cases, a person may in fact lack empathy in a medical or legal sense—the serial killer, the psychopath, and persons suffering from mental illnesses, or, more sympathetically, one of the disorders of empathy such as an autism spectrum disorder. However, such persons are exceptions or in an exceptional situation. 

In most cases, individuals have a significant empathic ability with which the individual is out of touch. The person lacks self-knowledge, has a blind spot, and does not know himself to be empathic. The person’s empathy is implicit and is waiting to be expanded. Therefore, a rigorous and critical guide calls out for expanded empathy—to leverage the kernel of empathy that already exists in the person’s humanity and develop it, if not into a mountain, at least into a heaping hill of empathy. 

One reason that empathy training programs have not worked or have produced disappointing results is that they train the participants in compassion, being nice, conflict resolution, baby and child care, and a number of worthy and admirable skills. This is all well and good, and the use of compassionate methods is making the world a better place in all these situations. So keep it up. There is nothing wrong with reducing conflict, being nice, agreeable, and so on: do not be “unnice.” But paradoxically something is missing—practicing a rigorous and critical empathy. 

Now I do not wish to give anyone a bad name, especially anyone who is committed to empathy, compassion, conflict resolution, or making a difference in overcoming human pain and suffering. On the contrary, I acknowledge and honor one and all. The battle against suffering is joined; we are all on the same side; and we want to deploy our resources wisely.

As soon as one announces a commitment (for example): “I am going to expand empathy in my life,” then all the reasons that it is utterly impossible to do so show up. “What are you thinkin’ fella?” Not enough time. Not enough money.   Resistance to empathy does not mean that one fails the readiness assessment to expand one’s empathy. It means that one is a human being. 

People have blind spots about empathy. People have blind spots, period.  Part of the readiness assessment? Those who take the implicit bias test discover they have biases—often several (see Teaching Tolerance 2020). When it comes to doing the work required actually to listen and respond empathically to others, people make exceptions for themselves—and their biases and inauthenticities. No exceptions!

The one question readiness assessment for empathy is: “Am I ready to do what it takes to clean up my inauthenticities in my practice of empathy?” (Key term: clean up.) Even if you are not completely sure what this means, being willing to agree to the statement is enough to get started. 

When it comes to a readiness assessment, the “willingness” is easy. Speaking personally, even lazy people can get their heads around willingness; and once a person puts his foot out onto the slippery slope of willingness, well, it is downhill all way. Sliding downhill may have its occasional bumps, and you have to apply the brake at times; but it is a lot easier than climbing up the hill. 

Look it, dude. I would be kidding you if I said no effort is required. Effort is required to expand your empathy. It is going to take something—and, at times, something extra by way of effort. Mostly it requires taking an honest look at oneself. That is not trivial. It may be confronting. But if you are getting vicariously traumatized trying to be empathic, then you are doing it wrong. Throttle back. Take a break. 

Being willing to clean up one’s authenticities is precisely the empathy lesson. The “gotcha” is that the inauthenticities in one’s life are not limited just to empathy. However, empathy leads the way. The readiness for a rigorous and critical empathy requires, well, rigor and a willingness to be self-critical. The readiness for empathy requires doing the work required to create a clearing for empathic success, a clearing of integrity and authenticity. 

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

Freud is explicit about his commitment to empathy. He writes and publishes the following:

It is certainly possible to forfeit this first success [in therapy] if one takes up any standpoint other than one of empathy such as moralizing (“Further recommendations: On beginning the treatment.” Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume 12: 121-144. : 140).

Unfortunately no one knows that Freud wrote that, because it is literally lost in translation. In translating “empathy [“Einfühlung”] from the original German, Alix Strachey writes to James Strachey: “In any case, it’s a vile word [“empathy”], elephantine, for a subtle process.” The words “sympathetic understanding” were chosen as the translation in this case. The rest, as they say, is history; except that it is like Russian history when Stalin had Trotsky’s photos literally cut out of the history books of the Russian Revolution. Talk about repression! 

[Note: This post is an excerpt from Chapter Four of my book A Rumor of Empathy: Rewriting Empathy (Palgrave Publishing): to buy the book or have your local library order a copy go here: get A Rumor of Empathy: Rewriting Empathy [https://tinyurl.com/y24ps876]]

Freud’s method was an empathic one, and the dispute, if any, is not that Freud did not use or value empathy. He did. Freud applies empathy in his clinical practice, even when he does not use the word “Einfühlung.” Freud balances his commitment to empathic methods even in the face of the boundary issues of C. G. Jung and S. Ferenczi with their women patients, where Freud took the moral high ground, counseled the need to be dispassionate and “like a surgeon” in neutrality, anonymity, and (above all) abstinence. However, that may all be well and good in practice, but how does that work in theory?  

In theory Freud limited his explicit mentions of “empathy.” The reason is Freud’s definition of “introspection.” Introspection is distinct from empathy, but closely connected to it. One dominant modern definition of empathy is “vicarious introspection” (Kohut 1959), where introspection is the royal road to empathy. Introspection is an anchor, making available the spontaneously arising vicarious feelings that are further processed by empathic understanding and interpretation into an empathic response. Yet Freud did not make such a distinction. Rather Freud defines “introspection” in terms of the self-observation of the conscience (one aspect of the superego), that is, as a form of self-criticism and censorship.

In this quotation, empathy is distinguished from “moralizing.” This is a casual reference but a potentially revealing one. By “moralizing” one understands Freud to mean the use of “approval” or “blame” as means of influencing the course of treatment. The exclusion of an ethics of empathy does not rule out the use of empathy for recognition of the humanity of the other person. In this sense, empathy implies a respect for the autonomy of the other which is inconsistent with any attempts to manipulate him by means of approbation and punishment. It is important to keep open a space for the ethical implications of empathy without indulging in “moralizing” in the narrow sense.

As noted,, this is also the text in which “Einfühlung[empathy]” is mistranslated by Strachey as “sympathetic understanding,” thus further obscuring the critical role that it takes in Freud’s practice. Contrary to Strachey, Freud takes significant effort to distinguish “empathy” from “sympathy.”

The effort to distinguish “empathy” from “sympathy” continues in Freud’s “Preface to Aichhorn’s Wayward Youth”(1925: 273). Sadly, so does the mistranslation. Freud acknowledges the contribution of August Aichhorn in working with troubled adolescents: “His [Aichhorn’s] attitude to his charges sprang from a warm sympathy with the fate of those unfortunates and was correctly guided by an intuitive perception [“intuitive Einfühlung” = “intuitive empathy”] of their mental needs.” 

The use of “intuition” here is not the over-intellectualization about which Kohut cautioned (e.g., Kohut The Analysis of the Self: 302-305), but rather the recommendation to be guided in relating to the troubled adolescent by one’s perceptive personal reaction, a skill in which Aichhorn excelled.

Freud typically finds a model taken from everyday life for pathological phenomena. Examples include: mourning (normal) and melancholy (depression); dreams (normal) and hallucinatory psychosis (waking dream); religious practices (normal) and obsessional rituals (pathological); love (normal) and hypnosis (abnormal): all present parallels between the everyday and the pathological. Thus, Freud notes the continuum between the pathological state of paranoia and the self-observations of the scrupulously moral conscience:

. . . The self-criticism of conscience is identical with, and  based upon, self-observation. That activity of mind, which took over the function of conscience, has also enlisted itself in the service of introspection, which, in turn, furnishes philosophy with the material for its intellectual operations. This must have something to do with the characteristic tendency of paranoiacs to form speculative systems.

It will certainly be of importance to us if we can see in other fields evidence of the activity of this critically watching faculty, which becomes heightened into conscience and philosophic introspection (Recommendations for physicians beginning psychoanalysis, 1914: 96-97).

This definition of introspection as critical self-observation is far from the kind of introspection actually practiced by both the analyst and analysand. The latter’s free associations cannot be generated so long as the conscience is actively censoring one’s thoughts and discourse. The analyst does not deliberately concentrate his attention or listen for anything specific in the analysand’s free associations.

The analyst maintains an attitude of evenly-hovering attention, in which his tendency to “moralize”—approve or blame—is suspended. In this way, introspection on the part of the analyst can disclose vicarious feelings as well as memories analogous to those told by the analysand. In both cases, we have a kind of introspection without inspection (to coin a phrase), which conditions the arousal of empathic receptivity towards the latent content of the analysand’s unstudied associations.

Rehabilitating introspection without inspection is based on an account of empathic receptivity. In so far as empathy is a kind of vicarious introspection, Freud’s ambivalence towards introspection constrains his use of empathy. Having a limited conception of the uses of introspection as “moralistic,” critical self-observation in philosophy constrained Freud’s explicitly using empathy as a means of empathic receptivity towards the introspective accounts of the analysand and the analyst’s own vicarious feelings thus aroused.

 In short, Freud’s methods and listening were highly empathic, and if one’s experience today is otherwise, it is only because something has been lost in translation – empathy. 

“Okay, I’ve read enough; I want further details”: to buy the book or have your local library order a copy of this book or another of Lou’s empathy books go here: get A Rumor of Empathy: Rewriting Empathy [https://tinyurl.com/y24ps876]  

Freud’s empathy: Freud depicted in front of the empathy control panel: Empathy is a dial, not an on-off switch

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

Empathy: A Lazy Person’s Guide is a light-hearted look at a significant and engaging matter: how to expand empathy in the individual and the community – and do so without working too hard. The Guide includes twenty eight illustrations by the celebrated artist Alex Zonis. So if you get tired of reading, look at the pictures! Practically an art book, get a summary in line below and order the book here and now by clicking here: Empathy: A Lazy Person’s Guide.

Given current events (Q2 2020), go straight to the section on applying empathy to soothe anger and rage – and setting empathic limits to drive out bullying, prejudice, and bad behavior. In addition –

A lazy person’s guide to empathy guides you in –

• Performing a readiness assessement for empathy

• Cleaning up your messes one relationship at a time.

• Defining empathy as a multi-dimensional process.

• Empathy in the age of coronavirus – don’t miss it!

• Overcoming the Big Four empathy breakdowns.

• Applying introspection as the royal road to empathy.

• Identifying natural empaths who don’t get enough empathy – and getting them [oneself] the empathy one needs.

• The one-minute empathy training. [No kidding!]

• Compassion fatigue: A radical proposal to overcome it.

• Listening: Hearing what the other person is saying versus your opinion of what she is saying.

• Distinguishing what happened versus what you made it mean.

• Applying empathy to sooth anger and rage.

• Good fences (not walls!) make good neighbors: About boundaries.

• How and why empathy is good for one’s well-being.

• Empathy and humor.Empathy, capitalist tool.

• Empathy: A method of data gathering.

• Empathy: A dial, not an “on-off” switch.

• Assessing your therapist,.

• Applying empathy in every encounter with the other person – and just being with other people without anything else added.

• Empathy as the new love – so what was the old love?

The lazy person’s guide to empathy offers a bold idea: empathy is not an “off-off” switch, but a dial or tuner. The person going through the day on “automatic pilot” needs to “tune up” or “dial up” her or his empathy to expand relatedness and communication with other people and in the community.

Practicing empathy includes finding your sense of balance, especially in relating to people. In a telling analogy, you cannot get a sense of balance in learning to ride a bike simply by reading the owner’s manual. Yes, strength is required, but if you get too tense, then you apply too much force in the wrong direction and you lose your balance. You have to keep a “light touch.” You cannot force an outcome. If you are one of those individuals who seem always to be trying harder when it comes to empathy, throttle back. Hit the pause button. Take a break.

Empathy is about balance: emotional balance, interpersonal balance and community balance. Empathy training is all about practicing balance: You have to strive in a process of trail and error and try again to find the right balance. So “lazy person’s guide” is really trying to say “laid back person’s guide.” The “laziness” is not lack of energy, but well-regulated, focused energy, applied in balanced doses. The risk is that some people – and you know who you are – will actually get stressed out trying to be lazy. Cut that out! Just let it be.

The natural empath – or persons experiencing compassion fatigue – may usefully “tune down” their empathy. But how does one do that?

The short answer is, “set firm boundaries.” Good fences (fences, not walls!) make good neighbors; but there is gate in the fence over which is inscribed the welcoming word “Empathy.”

The longer answer is: The training and guidance provided by this book – as well as the tips and techniques along the way – are precisely methods for adjusting empathy without turning it off and becoming hard-hearted or going overboard and melting down into an ineffective, emotional puddle.

Empathy can break down, misfire, go off the rails in so many ways. Only after empathy breakdowns and misfirings of empathy have been worked out and ruled out – emotional contagion, conformity, projection, superficial agreement in words getting lost in translation – only then does the empathy “have legs”. Find out how to overcome the most common empathy breakdowns and break through to expanded empathy – and enriched humanity – in satisfying, fulfilling relationships in empathy.

Okay – I have read enough – I would like to order the book: click here: Empathy: A Lazy Person’s Guide.

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

Class starts Tuesday March 28th. Empathy is oxygen for the soul. So if you are feeling short of breath due to life stresses, perhaps one needs expanded empathy. Get some here. This is what you need to know to

Gustav Klimt Death and Life: Detail

register. Further details on the course content are in line below. To register for the course, you need to provide basic info and register with the UChicago Graham School of Continuing Education. If you have any special requests, none of this is “chiseled in stone” yet (though it will be by 03/21/2017), so see my contact data below and let me know. There are no prerequisites or grades. This is Continuing Education. Cost is $360.