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Conclusion (Part 3): Empathy as Spa Treatment for the Soul – Connecting the Dots
Connecting the dots: stress and inflammation
Chronic inflammation is associated with auto-immune disorders such as asthma, irritable bowel syndrome (IBS), metabolic disorders, and allergies with which many people struggle, thereby finding their vitality reduced. People sometimes respond to these disorders by engaging in proper self-care, daily exercise, and well-balance diets. People also respond by engaging in self-defeating behaviors. People try to self-medicate with alcohol. They try to regulate and regain their emotional equilibrium in the face of social stressors by acting out in way that sabotage their own long-term well-being.
Listen to this past as a podcast on Spotify:
Note this post is not a written transcript of the podcast. It is a different performance of the same content as a spoken word (audio) presentation.
Lack of exercise and poor nutritional choices along with excessive use of alcohol, street drugs, gambling, sexual misadventures, binging, and chronic subclinical sadness belong on the list of self-defeating behavioral reactions.
The bottom line? When people practice healthy responses, not self-defeating ones, the body mobilizes and applies its infection fighting responses to social stressors, even though the latter are not infections. This makes considerable sense if one considers that an adaptive response to overwhelming social stress is to withdraw from the conflict and retreat to “sickness behavior.” The stressed-out individual retreats and avoids the stressful situation. The body makes one do this as a survival mechanism, getting out of a situation perceived to be “no win,” even if one’s stubbornness of spirit would make one willing to fight on. Never was it truer, the spirit is willing, but the flesh is weak.
The socially defeated person nurses his emotional wounds, as noted, by going to bed, with reduced appetite, lower energy, less enjoyment, less attention, and a need for sleep. The person finds his emotional and physical resource depleted. He takes to his “nest” to recover; and here is the punch line: The person acts depressed.
Additional evidence of the link between inflammation and symptoms of depression comes from modern cancer treatments.[i] Cancer treatments target tumors and cancerous processes by means of interventions that simulate immune systems reactions. These reactions use the above-cited cytokines called “interleukon” and “interferon.” One result of the cancer treatments that surprised cancer doctors is that patients receiving such interventioilns succumbed to depression. They satisfied clinical criteria for major depression disorder (MDD).
Note that the person receiving the treatment was not depressed beforehand. The person was not depressed because they have cancer, which can indeed be a “depressing” thing. No, the depression occurs even in people who have a positive attitude and are energetically fighting the disease, who otherwise feel okay emotionally. The symptoms of depression are evidentially a side effect of the treatment (albeit one which is not as toxic as the cancer itself). As a further confirmation of this, the side-effect yields to pharmacological treatments of depression such as antidepressants, and the person regains their standard non-depressed outlook once the cancer treatment is finished.
Psychologists Suzanne Segerstrom and Gregory Miller demonstrate that the immune system is not as autonomous as it was once thought to be.[ii] The immune system provides a pathway for the environment to influence the regulation of genes. Note that to be fully buzzword compliant “epigenesis” is the process by which the environment influences the regulation of the biologically given set of genes with which the person is endowed at birth.
Popular biological wisdom is that a person’s genes are like a set of cards in a “no draw” game of poker that one is dealt at the beginning. You play the hand you are dealt without being able to exchange any cards. Even if you don’t like a card you are dealt, you cannot change it. On the contrary, the approach of epigenesis says, “Yes, you still have to play the hand you are dealt, but you get to exchange a couple of cards,” based on interacting with the environment.
The physical and social environments do not just cause occasional, rare random mutations on genes; the environments are critical in activating or deactivating existing genes to produce diverse expressions of our biological capabilities, our biological selves. In short, the interaction is two-way, both from the genes to the organism and from the organism and its environment to the genes (or more properly speaking, the “genome,” the set of genes that includes all the genetic material governing the organism’s survival). Now add the stresses of the social environment to the physical mix of stressors.
According to Segerstrom and Miller, the immune system responds to signals from the body’s nervous system and the endocrine system. The immune system is modifiable and responds to the signals of cytokines and macrophages as they produce antibodies to fight bacterial diseases. This is where things get interesting.
Environmental stressors, to which the nervous system and endocrine system respond, elicit responses from the immune system by way of activation of genetic mechanisms that, in turn, perform protein synthesis, a major path by which the organism responds and attempts to maintain its equilibrium and well-being.
Strictly speaking, stress affects the immune system in at least two ways. Stress does not always reduce immunity. It tends to reduce—“down regulate” is the term of art—the anti-viral response (viruses being a different form of attack than bacteria); and it tends to “up regulate” the response to wounds and bacterial infection. Due to the production of inflammatory substances designed to combat a bacterial infection (which bacteria does not exist in the scenario of chronic social stress), the individual becomes vulnerable to life style and autoimmune disorders.
Subclinical physical problems tend to get emotionally and psychically elaborated in notoriously difficult to manage inflammations that manifest themselves as head aches, irritable bowel, asthma, allergies, lower back pain, and so on.
The best defense is often a good offense. Apparently the immune system agrees. Whether due to the haphazard design of the immune system or a defect in encoding the symbolic threat, the immune system counter-attacks against stress as if it were an all out attack by an infectious agent or wound.
In the case of chronic stress, the side effects of the counter-attack are inflammation. When the stress is chronic, the inflammation becomes chronic, too. This is the situation of many contemporary, stressed out individuals, struggling to survive modern life. The resulting “gotcha” is that many chronic stressors are largely symbolic. The stressed out person is not threatened by physical danger. The outcome is commonly observed: people who are chronically “stressed out” tend to get more colds and flu due to the down regulation of the anti-viral response.
The cytokine theory of depression shows us some of the diverse ways by which people express their stress and suffering. The cytokine theory of depression indicates that people express their chronic stress by displaying “sickness behavior.”
How does it work, and what to do about it?
Under standards conditions of moderate stress, the body regulates its own inflammatory activity. The neuroendocrine system regulates the body’s response to stressors. Substances called steroids—“glucocorticoids”—are released to balance and limit the inflammatory action. However, in chronic stress the process of regulation goes astray.
The hypothalamic-pituitary-adrenal (HPA) axis is a major part of the neuroendocrine system. This set of functions is a part of the lower brain stem. It regulates the body’s reaction to external stressors by providing energy and focusing attention. (Granted, the adrenal glands are not located in the brain, but interact with it.) The HPA axis gets activated to release these and related steriods.
However, under chronic stress, the glucocorticoid receptors seem to get fatigued. In effect, the receptors get “stressed out.” They become less responsive when they are under chronic stress, constantly being over-stimulated, in a process that is not well understood. This phenomenon is called “glucocorticoid insensitivity.”
For example and as near as we can tell, Slavich and Cole report that steriod—“glucocorticoid”—receptors typically act to “turn down” the production of inflammation-related substances. However, during chronic psychosocial stress or actual threat, glucocorticoid receptors fail to “down regulate” the glucocorticoid responsive genes the way they are supposed to do so. This is in spite of the glucocorticoid levels being either normal or elevated.[iii] They stop working or are no longer effective in countering inflammation.
Further confirming this troubling outcome, a correlation was found between immune function and cortisol levels in depressed patients.[iv]The result is the sickness behavior that we have been describing as the body’s inflammatory response is prolonged.
Notice that these steriods then become an indicator—a “bio marker” to use the technical term—of stress. In fact, the steriods are anti-inflammatory and anti-stress; but the body has stopped responding to them; and so they continue to “float around” in the organism, getting correlated with stress without functioning effectively as the anti-inflammatory substance that they are supposed to be. This is something that the popular treatment of cortico-steriods has sometimes gotten mixed up.
For example, in an otherwise penetrating and incisive treatment of stress, Arthur Ciaramicoli describes cortisol as a stress hormone. Cortisol is a villain in this narrative, and stress reducing or promoting activities are narratively associated with its departure or arrival. “Correlation is not causation” strikes again. Nevertheless, his conclusions about the value of dialing up empathy and dialing down negative self-talk through understanding and empathic responsiveness remains valid. The initiative to “wrapper” the skills training and tips and techniques of CBT in an empathic cacoon is a worthy one. [v]
In “stressed out” people, steriods as a group (including cortisol) are anti-inflammatory hormones that are not working as designed. The idea is that body was never designed to deal with chronic social stress as it occurs in modern, technological society, and further innovations or simplifications are needed to overcome the challenge of responding to the stress.
The meta-analysis of some 30 years of research by Segerstrom and Miller reports a significant association of depression (and chronic inflammation) with coronary heart disease, rheumatoid arthritis, stroke and other diseases where macrophage activation occurs. The authors account for the 3:1 female/male incidence of depression ratio by estrogen’s ability to activate macrophages; and the relatively low rate of depression in Japan as consistent with the suppressive effect of fatty acids and fish oil on macrophages.[vi]
According to Segerstrom and Miller’s interpretation, “depression” is a redescription of “inflammation.” If you are depressed, you need anti-inflammatory intervention.
A major depressive disorder involves real suffering, and in no way does one want to make light of such suffering. Nevertheless, the “out of the box” redescription cited-above suggests that you are not really depressed, you just have an inflammation. Aspirin is an anti-inflammatory. Therefore: “Take two aspirin and call in the morning.” Pause for a laugh. This unsubtle joke, which you must admit is suitable for polite company, made many of my MD colleagues laugh out loud; and it points to the reason why this approach to depression has not received more attention, though it has been validated and available since at least the mid-1990s:[vii]
- It would mean having to develop an entire class of anti-inflammatory antidepressants, which, in turn, would potentially undercut the vast existing market of antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) (of which the “poster child” is Prozac).
- It is by no means clear that such development of a new class of drugs would be feasible or (more to the point) profitable.
- Alternative interventions already exist that reduce stress and inflammation—and empathy is towards the top of the list of those.
We take a step back and note that, with the publication of Peter Kramer’s Listening to Prozac (1991), pharmacological interventions for depression knocked the legs out from under all forms of talk therapy.
Even if SSRIs (such as Prozac (the brand name for fluoxetine)) have not lived up to their initial, exaggerated promise, the economics of current medical system prescribing prefers fifteen-minute medication management sessions over forty five minute conversations for insight and possibility.
The reimbursement system is adhering to this assessment even in the face of the hard-to-quantify trade-offs between quality and quantity.
The conversation about evidence-based treatment is stuck in a loop of an either/or preference for medication over conversation. Evidence is available for the efficacy of each in sometime diverging, sometimes overlapping contexts. The economics of talk therapy, even CBT, are under-privileged and marginalized by many insurance payers and their practitioners.
This raises the engaging question of how SSRIs intersect with those depressed individuals, whose biomarkers show increased pro-inflammatory immune response and related increases in glucocorticoid resistance, matching the previously described effects of major depressive disorder.
As this book goes to press [Q1 2018], results are inconclusive. High blood serum levels of serotonin are completely consistent with high biomarkers for inflammation and vice versa. One likely possibility, though speculative, is that “major depression” is not a natural category; and one can obtain the symptoms of major depression defined in the Diagnostic and Statistical Manual (any version) by multiple molecular pathways.
Once again, it is speculation, but just as scientific advances are showing that cancer is not a single disease at the molecular level, so too depression may well turn out to be multi-dimensional and not a single disorder. Nevertheless, this brings us back to the question; People are stressed out—suffering—what do we do about it?
Connecting the dots: anti-inflammation and empathy
This just in. The patients of medical doctors who score well on tests for empathy have superior control over their “bad” cholesterol in comparison with those who score less well. (In fact, this is not “just in,” but was published in 2011 as indicated in the next end note.)
M. Hojat and his colleagues found that patients of physicians with high empathy scores were significantly more likely to have good control of hemoglobin A1c (56%)—a bio-marker for diabetes—than were patients of physicians with low empathy scores (40%, P .001).
In addition, Hojat reported that the proportion of patients with good control over low density lipid cholesterol (LDL-C)—the so-called “bad” cholesterol—was significantly higher for physicians with high empathy scores (59%) than physicians with low scores (44%, P < .001).[viii]Hojat also reported that the physician’s empathy had a unique contribution to the prediction of optimal clinical outcomes even after controlling for the physician’s and patient’s gender and age, and the patient’s health insurance.
Thus, anti-inflammatory interventions exist that have been shown to make a difference in controlled experiments, evidence-based research, and peer-reviewed publications. Empathy is at the top of the list.
This bear repeating: empathy is at the top of the list, but is not the only thing on it. Spiritual practices such as Yoga, Tai Chi, mindfulness (meditation), also are on the list. These are not reducible to empathy (or vice versa), but they share a common factor: an outcome of reduced inflammation.
Stress reduction practices such as receiving empathy from one’s doctor put the person in touch with her or his immediate experience. They promote the person experiencing life without anything added, without filters, without labels and categories. And in specific cases (cited below), they can be shown in evidence-based studies to reduce the bio markers of stress and stress-related life style disorders such as high cholesterol, diabetes type 2, and so on. People tend to feel better, perform better, enjoy expanded vitality in conjunction with these practices. Therefore, we shall cast a wide net in gathering reminders as to how to reduce stress in such a way that the stress reduction practices gets inside the body and make a difference.
The empathy lesson? Peer-reviewed research studies have provided an evidence-based link between practitioners who deliver empathy to their patients and favorable healthcare outcomes. What is interesting is that these evidence-based studies exclude psychiatric disorders and emphasize outcomes for life style disorders such as reduced cholesterol and type 2 diabetes in order better to isolate and control the empathic input to the process, which is otherwise so pervasive in a psychiatric context.
A separate study by Del Canale and colleagues showed that physicians with high empathy scores had patients with significantly fewer metabolic complications from diabetes.[ix]
The study concluded that these results indicate physician empathy is significantly associated with clinical outcome for patients with diabetes mellitus and should be considered an important component of clinical competence. It gets better—for empathy. These are not just “one off” studies. A meta-study of healthcare outcomes across all kinds of doctor visits, in which objective measures such as blood pressure were available, indicated a significant correlation between empathy and favorable outcomes.
In the meta-study, John Kelly and his colleagues, including Helen Riess, report on empathy publications of randomized control trials (RCTs) in adult patients. In these RCTs, the patient-clinician relationship was systematically manipulated and healthcare outcomes were either objective (e.g., blood pressure) or validated subjective measures (e.g., pain scores). A broad and diverse variety of disorders were engaged empathically. Disorders studied included patients with diabetes, osteoarthritis, fibromyalgia, lower respiratory infection, oncology, osteoarthritis, hypertension, smoking, somatic complaints, and asthma. The median patient sample size was 279 (range: 85 to 7,557).
The researchers acknowledge that they cannot be sure if, in the context of empathic medical practice, the favorable outcome is due to improved compliance with physician guidance, patient motivation to take action to recover well-being, education, the self-healing properties of the body under reduced stress (my favorite interpretation), or (mostly likely) a combination of factors. On the one hand, further research is needed; on the other, results are results. Once again, correlation points to a significant path to improved outcome through empathic treatment, but is not causation.
With that caution in mind, empathy has been shown to correlate with reduced duration of the common cold. Now no one is saying that empathy is the cure for the common cold; but the results are definitely suggestive of the healing powers of stress reduction: “In those physicians with perfect CARE scores (Consultation and Relational Empathy), cold durations were shorter (mean 7.10 days versus 8.01 days) [….] In these models, a perfect score also correlates with a larger increase in IL-8 [(interleukin 8) a cytokine] levels.”[x] That is, the immune response was increased.
The researchers further engaged and evaluated immune response by measuring concentration of interleukin 8 (IL-8) from nasal wash specimens at enrollment and at a follow-up visit some 48 hours later. IL-8 is an inflammatory cytokine found in nasal secretions. It increases with viral upper respiratory infection. It is reportedly one of the best, single markers of immune response for upper respiratory infections acquired in a community setting; it correlates well with symptoms; and is reliably measured. If we look carefully, we can see the hype in the media and press coming into view
The researchers concluded that empathy, as perceived by patients having a common cold, significantly predicts subsequent duration and severity of illness and is associated with immune system changes. My conclusion? Do not under-estimate the healing powers of empathy!
However, empathy is not the only intervention that correlates with improved results. Other practices such as meditation (mindfulness), sitting, yogic meditation, and Tai Chi produce a similar result. Several paths are available to stress reduction. We look at these alternative paths.
For example, W. W. Thaddeus Pace and his colleagues at Emory University report that meditation practices impact physiological pathways, including the immune and neuroendocrine systems, which are regulated by stress and are relevant to diverse diseases.[xi] How could they possibly know? The researchers divided people into meditators and non-meditators for testing. The researchers took blood (plasma) samples, and reported the results.
In plain English, the bio-markers of stress went down significantly for those engaging in meditating compassionately, thinking kind thoughts and thinking charitable thoughts. The researchers report that physiologic and behavioral responses to the tier social stress test (TSST) were determined by repeated assessments of plasma concentrations of interleukin (IL-6) and cortisol as well as total distress scores on the Profile of Mood States (POMS). For the meditating group, increased meditation practice was correlated with decreased IL-6 and improved distress scores. More evidence proving common sense? Individuals who meditated more enjoyed proportionally reduced stress.
The researchers cautiously conclude that engagement in compassion meditation (thinking kind thoughts, being charitable in one’s thoughts) may reduce stress-induced immune and behavioral responses. Once again, empathy and compassion are distinct; but both get one in touch with one’s own experience in such a way that one is accepting of whatever it is that one is experiencing, thereby reducing conflict and enabling the spontaneous stress reduction process to get traction.
Family members and care-takers that provide support and care for people with Alzheimer’s or other forms of dementia are vulnerable to a variety of stress-related disorders. Providing such care is extremely stressful for many reasons, including the inability of the patient to acknowledge the contribution of the care-taker and the destructive nature of the disease (i.e., the frequent absence of an empathic response). David Black and his colleagues Steve Cole and Michael Irwin (and others) at the University of California, Los Angeles, reported that dementia caregivers who practice meditation show improvement in their own mental health indices such as depression and anxiety, which are indices associated with inflammatory markers such as IL-6. [xii]
Black and Cole investigated if yogic meditation changes the activity of inflammatory and antiviral pathways that shape gene-mediated immune system response. Forty-five family dementia caregivers were randomized either to Kirtan Kriya Meditation (KKM) or Relaxing Music (RM) listening for 12 minutes daily for 8 weeks and 39 caregivers completed the study. Genome-wide transcriptional profiles were collected from peripheral blood leukocytes sampled at baseline and 8-week follow-up.
Without going into the wealth of details provided here, the researchers identified a reversal of patterns previously linked to stress. Their study concluded that a brief daily yogic meditation intervention reverses the pattern of increased pro-inflammatory cytokines and decreases antiviral response genes previously observed in healthy individuals confronting a significant life stressor.
Eight weeks of structured yogic meditation reversed patterns of increased pro-inflammatory genes and decreased genes previously associated in healthy individuals with reduced inflammation. Meditating reduces stress and enhances immunity.
The authors generalized that adverse life events such as “social isolation, imminent bereavement, PTSD, chronic loneliness, social stress, and low socioeconomic status” increased inflammation-related gene activation and decreased the activity of innate antiviral genes. Once again, meditating reduces stress and enhances immunity.
Michael Irwin and Richard Olmstead reported on the stress reducing properties of Tai Chi Chin ((TCC) a “soft” Chinese martial art that practices continuous, slow motion flowing movements). The researchers describe TCC as a behavioral intervention. Practicing it daily reduces circulating levels of inflammatory bio-markers (interleukon-6 (IL-6)) in older adults (the target population in the study). These individuals are frequently at risk for inflammation-related illness. The researchers note that their findings are consistent with high rates of depressive disorders in persons with inflammatory disorders. They cite evidence that experimental activation of inflammatory signaling induces feelings of social withdrawal, depressed mood, and anhedonia. The researchers cautiously report that circulating levels of inflammatory markers rise with age even in healthy individuals, and the proportion of persons with elevated levels of IL-6 rises markedly among persons older than seventy years, increasing the risk of inflammation related disorders (e.g. cardiovascular disease and heart failure, cancer, Alzheimer’s, related neurodegenerative diseases, metabolic alterations, and diabetes). [xiii]
Generalizing on this research, a small set of practices such as receiving empathy, meditation (mindfulness), yogic meditation, and Tai Chi, promote well-being by reducing inflammation. These practices are not reducible to empathy (or vice versa), but they all share one single, common factor: reduced inflammation. These anti-inflammatory interventions have been shown to make a profound difference in controlled experiments, evidence-based research, and peer-reviewed publications. Empathy is at the top of my list, but is not the only item on it. Empathy along with mindfulness (a form of meditation), Yoga, Tai Chi, spending time in a sensory deprivation tank (not otherwise discussed here), and certain naturally occurring steroids, need to be better known as interventions that reduce inflammation and restore homeostatic equilibrium to the body according to evidence based research.[xiv]
In summary, when bacteria attack the human body, the body’s immune system mounts an inflammatory defense that sends macrophages to the site of the attack and causes “sickness behavior” in the person. The infected person takes to bed, sleeps either too much or too little, has no appetite (or too much appetite), experiences low energy, possibly has a fever, including the “blahs,” body aches, and flu-like symptoms. This response has evolved over millions of years, and is basically healthy as the body conserves its energy and fights off the infection using its natural immune response.
Now fast forward to modern times. This natural response did not envision the stresses of modern life back when we were short stature, proto-humanoids inhabiting the Serengeti Plain and defending ourselves against large predators. Basically, the body responds in the same way to the chronic stressors of modern life—the boss at work is a bully, the mortgage is over-due, the children are acting out, the spouse is having a midlife crisis—and the result is “sickness behavior”—many of the symptoms of which resemble clinical depression—but there is no infection, just inflammation. The inflammation becomes chronic and the body loses its sensitivity to naturally occurring anti-inflammatory hormones, which would ordinarily kick in to “down regulate” the inflammation after a few days. Peer reviewed papers demonstrate that interventions such as empathy reduce biological markers of inflammation and restore equilibrium. This is also a metaphor, though not merely that. When an angry—“inflamed”—person is listened to empathically—is given a “good listening” as I like to say—the person frequently calms down and regains his equilibrium. Empathy migrates onto the short list of inflammation reducing interventions. The compelling conclusion is that empathy is good for your well-being.
Miracle drug
This entire blog post might have been entitled “Miracle Drug,” except that I have been “scooped” by Stephen Trzeciak, MD, and Anthony Mazzarelli, MD, in their similarly titled Wonder Drug.[xv] The rhetorical trick is that the reader is expecting to hear about a “breakthrough” psychopharmaceutical product such as Peter Kramer’s Listening to Prozac or a so-called third-generation anti-psychotic medication such as aripiprazole (“Abilify”).[xvi] Instead the reader hears about “empathy” and a set of empathically-related phenomena such as compassion, altruism, charitable actions, and being helpful to other people in ways large and small.
The point is that getting a good listening—a description of empathic receptivity—is a powerful intervention and one with significantly fewer side effects than a chemical compound. The point is that, as argued by evidence-based research cited in this blog post, that acts of empathic listening and responsiveness set in motion biological processes that reduce the quantity of stress related chemicals in the body, and do so “naturally,” i.e., without swallowing pills produced by pharmaceutical companies. These entrained biological processes, in turn, have results and outcomes that cause the person to feel better. The person’s vitality, strength, energy, and aliveness are expanded and enhanced. The reasons the person feels better are many, and the reasons vary according to the description that one gives of the intervention. The person feels better because he or she is no longer alone.
The isolation is broken by getting a good listening. The individual feels understood and sees the possibility of accomplishment, purposeful engagement, and getting what he or she wanted where previously there had been isolation and frustration. The person experiences expanded dignity, less emotional conflict, and a certain peace of mind, because the individual gets the recognition and dignity which had been missing in the individual’s life and for which the individual had been hungry. The individual gets empathy and is able to breathe again, because, the individual was being suffocated by stress, and empathy is like a breath of fresh air. Heinz Kohut famously wrote that empathy oxygen for the soul—without empathy in the individual’s life, the person is going to suffocate emotionally and exist without vitality, strength, energy, and aliveness.[xvii]
The person whose upbringing is empathy-deprived is going to experience human relations as being on a negative continuum between an emotional Zombie and a roller-coaster of disregulated emotions and behavior. This already takes matters in the direction of another level of discourse, biology versus interpersonal community, though (as far as I know) Kohut never commented in writing on the neurological, endocrinological, or metabolic aspects of empathy. Empathy and a small set of empathically-related phenomena reduces stress and the chemicals in the blood that cause inflammation. This opens up a different level of description and a different level of experience.
Trezeciak and Mazzarelli cite literally dozens and dozens of evidence-based, peer-reviewed articles, many published since the first edition of this book, that provide evidence that empathy creates a clearing for compassion, altruism, and kindness, and together these produce behavioral medicine that is good for one’s health and well-being.[xviii] And these men are medical doctors! At the risk of over-simplification, the underlying mechanism is stress reduction through reduced presence or production of inflammatory agents generated by the body in the face of life stress.
I hasten to add that there is nothing wrong with consulting with a medical doctor about properly prescribed psychopharmaceutical interventions, indeed it is highly advisable. Heck, if one is really planning on acting on one’s suicidal ideation, one had better take the medicine and live to fight another day. Nevertheless, for numerous less acute encounters with the stresses of everyday life—which can indeed be severe and confronting but nevertheless fall short of major mental illness—signing up for a psychopharmacological intervention can be a deal with the devil. Be sure to read the fine print. Be aware that sometimes the “side effects” are hard to distinguish from the “main action” of the medicine.
The effects of powerful psychopharmacological agents on the nervous systems, the emotions, and behavior are the subject of detailed evidence-based studies, most of which are highly qualified and conditioned, and it is hard, indeed nearly impossible, to generalize. Your mileage may vary, and note well that “all the usual disclaimers apply.” The one, best take-away recommendation that has severed all professionals well across numerous contexts is: “Don’t hurt yourself!”
So when one says that an empathic conversation for possibility is less risky and has fewer side effects than psychotropic chemicals, there is truth to it. By having an empathic conversation for possibility, one does not put a lot of drugs into one’s blood stream, the side effects of which (as the warning label on the package says) may be unpredictable, and the metabolic consequences of which are scientifically studied and approved by large governmental organizations, but of which the adverse events are not ruled out (again, as specified by the long list of warnings on the label). Now, as far as I know, people experience respect, dignity, recognition, acknowledgement, disappointment, insults, not oxytocin, serotonin, endorphins, dopamine, or approximately a thousand other neuropeptides. While science can demonstrate the occurrence and influence of such chemicals on mood and behavior—using correlation studies to infer causation—the risk is that the person will casually sacrifice individual autonomy to a medication regimen.
It is a category mistake—a logical error—to imagine that any narrative about the dynamics of neurotransmitters or neurons discharging can provide a meaningful account of human experience of satisfaction or fulfillment in empathically interacting with another human being. It is not that the neurotransmitter account is wrong. On the contrary, at its own level of discourse, it is necessarily an account of the dynamics of neurotransmitters. However, something significant is missing from that account—the relevance of human empathy to community and interpersonal relations.
The power of empathy should not be underestimated in comparison to these overtly chemical interventions. Most empathic conversations between adults occur in language and language is a powerful media. A group of mean teenagers bullied one of their peers into suicide using language and social media. To be sure, the victim was already struggling with low self-esteem, and tragically did not know how to use speech acts to ask for the help needed. However, the point about the power of language is that no chemicals, only language, was required by the bad actors. People speaking to other people use speech acts to motivate the Others to do things that occur on a continuum between inspired and foolish.
In a political context (see Chapter 10 of Lou Agosta, 2024, Empathy Lessons, 2nd Edition, on empathy and politics), written documents such as the Declaration of Independence (1776), the Declaration of the Rights of Man (1789), and the UN Declaration of Human Rights (1948) send fear into the hearts of tyrants everywhere, because they know a single fact, though fragile, is able to counter oceans of political propaganda, which, in turn, is why tyrants and demagogues try to control the news media. Though not about empathy as such, these documents show the power of language in the form of empathic responsiveness and rhetorical empathy[xix] to make a difference in envisioning expanded flourishing in human relations, which is also a goal of empathic relatedness.
[i] Yehuda Pollak and Raz Yirmiya. (2002). Cytokine-induced changes in mood and behaviour: implications for ‘depression due to a general medical condition’, immunotherapy and antidepressive treatment, International Journal of Neuropsychopharmacology, (2002) 5: 389–399. DOI: 10.1017/S14611457020 03152.
[ii] Segerstrom, Suzanne C. and Gregory E. Miller. (2004). Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry, Psychol Bulletin. 2004 July; 130(4): 601–630.
[iii] George M. Slavich and Steven W. Cole. (2013). The emerging field of human social genomics, Clinical Psychol Science, 2013 Jul 1(3): 331–348.
[iv] Yehuda Pollak and Raz Yirmiya 2002.
[v] Arthur Ciaramicoli. (2016). The Stress Solution: Using Empathy and Cognitive Behavioral Therapy. Novato, CA: New World Library. “CBT” means “cognitive behavioral therapy.”
[vi] Segerstrom and Miller 2004.
[vii] M. Maes. (1995). Evidence for an immune response in major depression: a review and hypothesis, Progress in Neuro-Psychopharmaclogy and Biological Psychiatry 19, 11–38; M. Maes. (1999). Major depression and activation of the inflammatory response system, Advances in Experimental Medicine and Biology 461: 25– 46.
[viii] Mohammadreza Hojat, Daniel Z. Louis, Fred W. Markham, Richard Wender, Carol Rabinowitz, and Joseph S. Gonnella. (2011). Physicians’ empathy and clinical outcomes for diabetic patients, Acad Med. Mar 86(3): 359–64.
DOI: 10.1097ACM.0b013e3182086fe1.
[ix] Louis Del Canale, V. Maio, X Wang, G Rossi, M. Hojat, and J.S. Gonnella. (2012). The relationship between physician empathy and disease complications: an empirical study of primary care physicians and their diabetic patients in Parma, Italy, Academic Medicine, 2012 87(9): 1243–1249.
[x] David P. Rakel, Theresa J. Hoeft, Bruce P. Barrett, Betty A. Chewning, Benjamin M. Craig, and Min Niu. (2009). Practitioner empathy and the duration of the common cold, Family Medicine 41(7): 494–501.
[xi] Thaddeus W.W. Pace, Lobsang Tenzin Negi, Daniel D. Adame, Steven P. Cole, Teresa I. Sivilli, Timothy D. Brown, Michael J. Issa, and Charles L. Raison. (2009). Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress, Psychoendocrinology, 2009 Jan 34(1): 87– 98.
[xii] David S. Black, Steve W. Cole, Michael R. Irwin, Elizabeth Breen, Natalie M. St. Cyr, Nora Nazarian, Dharma S. Khalsa, and Helen Lavretsky. (2013). Yogic meditation reverses NF-kB and IRF-related transcriptome dynamics in leukocytes of family dementia caregivers in a randomized controlled trial, Psychoneuroendocrinology, 2013 March 38(3): 348–355.
[xiii] Michael R Irwin and Richard Olmstead. (2012). Mitigating Cellular Inflammation in Older Adults: A Randomized Controlled Trial of Tai Chi Chih, American Journal of Geriatric Psychiatry, 2012 September 20(9): 764–722.
[xiv] M. H. Antoni, Lutgendorf, S. K., and Blomberg, B. (2011). Cognitive-behavioral stress management reverses anxiety-related leukocyte transcriptional dynamics, Biological Psychiatry, 2011, 15: 366–372; David Black, Steve Cole, Michael Irwin et al. (2013); Michael R Irwin and Richard Olmstead, 2012.
[xv] Stephen Trzeciak and Anthony Mazzarelli. (2022). Wonder Drug: 7 Scientifically Proven Ways That serving Others Is the Best Medicine for Yourself. New York: St Martin’s Press.
[xvi] Kramer, Peter. (1993). Listening to Prozac: The Landmark Book about Anti- depressants and the Remaking of the Self. Revised edition. New York: Penguin, 1997. Heinz Kohut. (1977), The Restoration of the Self, International Universities Press: 85, 251.
[xvii] Heinz Kohut, MD. (1977). The Restoration of the Self, International Universities Press: 85, 251.
[xviii] Pace, Thaddeus W.W., Lobsang Tenzin Negi, Daniel D. Adame, Steven P. Cole, Teresa I. Sivilli, Timothy D. Brown, Michael J. Issa, and Charles L. Raison. (2009). Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress, Psychoendocrinology, 2009, Jan: 34(1): 87–98; Nelson- Coffey S K, Fritz, M M, Lyubomirsky, S, Cole, S W. (2017). Kindness in the blood: A randomized controlled trial of the gene regulatory impact of prosocial behavior. Psychoneuroendocrinology. 2017 July; 81: 8–13; DiSalvo, D. (2009). Forget survival of the Fittest: It is kindness that counts.” Scientific American, Sept 1, 2009; Furman, D, Campisi, J, Berdin, E, et al. (2019). Chronic inflammation in the etiology of disease across the life span. Nat Med. 25 25, 1822–1832 (2019). As I understand matters, the idea that empathic concern creates an opening for altruistic, compassionate action is convincingly argued by C. Danial Batson in a series of experiments including C. Daniel Batson. (2009). These things called empathy Eight related but Distinct Phenomena. In The Social Neuroscience of Empathy, eds. Jean Decety and William Ickes. Cambridge, MA: The MIT Press, 2009: 3–16.
[xix] On rhetorical empathy see Lisa Blankenship. (2019). Changing the Subject: A Theory of Rhetorical Empathy. Logan UT: Utah State University Press. The reader will also encounter rhetorical empathy in Lou Agosta, 2024, Empathy Lessons, 2nd Edition, Chapter 10: Empathy Application: Rhetorical empathy—speaking truth to power in politics. The counter-intuitive thing about empathic responsiveness is that empathy is usually (and properly) regarding as an attitude of listening, but her the active listening becomes articulate and gives back to the Other what the listener heard in being receptive to the Other’s struggle or accomplishment. The speaking occurs in such a way that it includes the listening of the recipient, in other words, incorporates where the Other is situated affectively, ethically, cognitively, and/or spiritually, depending on the context.
Image credit: William-Adolphe Bouguereau (1825-1905) – At the Edge of the Brook (1879) thanks to WikiMedia Commons: Pubic Domain
(c) Lou Agosta, PhD, and the Chicago Empathy Project
Part Two: Empathy: Spa Treatment for the Soul: Against Stress
This is Part Two of the series on how empathy relates to reducing stress as a “spa treatment for the soul.” In order to understand empathy as a kind of antidote to stress, it is important to know the enemy – in this case, stress. Therefore, this discussion lays out the distinctions that help us understand what makes stress, well – stressful. The third and final part (due out in about a week will then bring it all back home with the evidence-based research on the stress reducing and well-being promoting properties of empathy and a set of related practices.
Listen to Parts 1 and 2 of the blog posts as a podcast on Spotify –
(Note this is not a transcript but a different performance of the same context as the text.)
Stress and inflammation: Some is good, too much is not
As my Grandma Laura understood implicitly (and as detailed in Part 1), stress reduces the body’s immune defenses. The person becomes vulnerable to disease. What is less well understood is how the body responds to social stress; and what the heck is “social stress” anyway?
We will precisely define all kinds of stress in the next section, but, for the moment, social stress is stress related to competition and conflict between people, who are trying to live together in a human community.
The body responds with an immune response, because social stress seems to simulate the attack of something coming at the person and the person’s body from the outside such as an infectious agent like a virus or bacteria. The immune system response to the perceived stress results in inflammation, which, in turn, aggravates emotional and psychosomatic disorders. The challenge is to connect the dots between stress, inflammation, physical diseases, emotional disorders, and then intervene with empathy to interrupt this negative cycle.
“Social stress” is a feature of life for people who have to work and live with other people, which, excepting a few hermits, is all people. Social stress includes the struggle and effort that people confront in careers, relationships, finances, scheduling, and sustaining emotional equilibrium.Social stress occurs in divorces, misbehaving kids, unemployment, adultery, and bankruptcies. Social stress occurs in the competition and aggression between people and groups such as bullying, office politics, stranger danger on the streets, and a host of interpersonal conflicts and pressures too lengthy to list here.
We have been using the word “stress” as if we knew what it is; and we do know a lot about stress from first-hand experience. Stress is a distressing part of life. Stress is di-stressing. Literally. Chronic stress is a pervasive challenge. However, the complete absence of stress is not an option. The complete absence of stress means you are dead—or at least in a persisting vegetative state. Not good.
Social stress is a substantial issue in attaining and managing physical and emotional well-being. It is no surprise that empathy has a significant role to play in shifting out of the stress with which the person is stuck and struggling. Let’s define our terms.
Stress comes in five forms
We use the word “stress” too casually as something to be avoided at all costs. As noted, we forget that zero stress means you are dead, a situation one generally tries to avoid. Yet engaging with stress is, well, stressful. Let us define “stress” and do so precisely by enumerating its different forms.
Stress comes in at least five forms:
(1) Acute, time-limited stressor: For example, public speaking is “an acute, time-limited stressor.”[i] When asked “What do you fear the most?” death comes in second place on the list. Number one is public speaking. People for whom public speaking is a stressor feel better as soon as they are able to step down from the podium. In contrast, for those who train as speakers and performers, the stress of speaking can act as a positive stimulant. If a trained speaker does not feel a touch of “butter-flies” in the stomach, prior to a performance, that is considered a bad sign. Such people get worried if they do not experience some stress; because they know the stress will provide them with the extra energy they need to deliver a compelling performance. Thus, stress has a wholesome, healthy dimension when it gets people “on their best game.”
(2) A personal, life defining challenge: People facing a crucial, life defining examination, such as the Bar Exam in law or Medical Boards, experience acute stress. This is different than “stage fright” in that it is not public. Yet one is being tested, judged, and evaluated by those in authority. The risk is of not looking good or not acquiring the required professional license. Still, the stress is time limited. Once it is over, pending a favorable outcome, the stress is noticeably reduced. Once again, some stress in anticipating the exam is useful in providing an incentive to prepare.
(3) Naturalistic stressors: Different kinds of natural or social events such as death of a family member, loss of a job, or divorce are stressful. These can be highly stressful; yet in every case, a definite end point exists that one can try to imagine. Mourning lasts about a year. People find other jobs. People meet new partners.
Many of the rituals surrounding the death of a person to whom one is close are designed to facilitate the process of working through the stress. Wakes and funerals, when they function as designed, are calculated to evoke stories about the loved one, and the accompanying tears and laughter serve to process the loss. The storytelling itself is the empathic moment, making present a response in the form of acknowledgement and recognition of the life of the lost loved one.
(4) Trauma as such: An event in the past that “lives on” emotionally such as the experience of war or rape is stressful. Even if the trauma is separated from the present by a significant interval of time, the stressor may live on. The person may experience and re-experience the trauma as intrusive thoughts, recurring nightmares, blunted affect, amnesia, avoidance, an exaggerated startle response, and so on. In short, criteria for post trauma stress disorder (PTSD) are satisfied, whether or not they rise to a clinically relevant level. This is chronic stress that does not quit.
The treatment of choice for stressors related to traumatic events that keep coming back and live on is described as “exposure.” The survivor is supposed to do that which he is least inclined to do: expose himself to the trauma again (but now in a controlled and gradual way), redescribing the upset imaginatively or vicariously. In redescribing the experience in relevant detail, the unintegrated emotions and feelings are given a chance to be re-experienced and integrated. The trauma shrinks. Do this repeatedly and the trauma shrinks repeatedly, little-by-little, step-by-step. The trauma becomes manageable, which means it stops being traumatic.
One gets one’s power back in the face of the upset whereas previously the event was an intrusive, monster-like interruption that one was trying to escape without noticeable success. For example, in eye movement desensitization routine (EMDR), the focusing on the back-and-forth movement of the light sequence or the therapist moving a baton, binds the patient’s attention (and potential fear) while he recalls, talks about, gives an account of, sometimes merely thinks about, and re-experiences the trauma in a non-traumatic, or at least trauma reducing, way. An entire account of trauma and recovery is implied here, and for further details the interested reader is referred to the relevant literature on trauma. [ii]
This is where empathy comes into its own as an intervention. What is often overlooked in accounts of such exposure-directed interventions is that, unless the re-experiencing is undertaken in the context of an empathic relatedness, it is like dental work without Novocain. Some patients who are hurting enough and courageous enough may stick with it; but many will just make other arrangements (such as drinking alcohol to excess), not come back, and continue to struggle in stuckness. The empathic relatedness provides the survivor with the empathic connectedness needed to risk diving again back into the emotional dimension of the trauma (which has previously been held at arms’ length), knowing that he can reconnect empathically with the facilitator to regain his emotional equilibrium.
(5) Long term stressors: Long term stressors are ones with no defined or obvious end in sight. Examples of long term stress include caring for a loved one who has a progressive, degenerative disease such as Alzheimer’s; suffering from a life-threatening or serious chronic disease oneself; loss of one’s home, that is, becoming homeless; being employed significantly beneath one’s educational level on a long-term basis; financial ruin due to illness or criminal behavior (think of Bernard Madoff’s Ponzi scheme that financially destroyed many middle class lives); legal troubles; growing up being African American in states where racially motivated lynchings occurred (or arguably, growing up African American anywhere in America); being a refugee or immigrant and a stranger in a strange land.
For example, the United Nations estimates that between (Q3 2017) and Q4 2022 the number displaced persons, refugees, in the world has increased from 60 to 108.4 million. Refugees are under extreme stress. In all of these cases, the stress is chronic and long term. The symptoms may or may not rise to the level of clinical post-traumatic stress disorder (PTSD); or the person may find other ways of responding to the distress and expressing the suffering. Self-defeating behavior, behavioral disorders, substance abuse, promiscuous unprotected sex with different partners or other forms of acting out, allergies, chronic hard-to-diagnose intermittent headaches, backaches, asthma attacks, irritable bowl, hard-to-diagnose chronic pain, and so on, are common.
Relatively fewer extreme examples such as social isolation, long term loneliness, low socio-economic status (poverty), being the target of repeated bullying, are less immediately destructive of one’s humanity. Yet the cumulative stress entailed is substantial.
From a completely different perspective, the modern, relatively well-to-do family has to run the gauntlet of seemingly endless micro-stressors. While not comparable with war or rape, “micro-stressors” are the abundant small insults, injuries, frustrations, and misfortunes that occur on a daily basis in fast-paced, modern life. These are “first world problems,” that end up taking seven years off of one’s life expectancy. Getting the kids up at an early hour and delivering them to school prior to a challenging commute to work is stressful. The boss at work is not necessarily an example of empathic understanding. On the contrary, it’s “by the numbers,” “get your numbers,” and if you don’t get your numbers, your days are numbered. If you don’t have any numbers, that itself is a bad sign, and we will find some for you. Relations with coworkers and superiors can be Machiavellian—and conflict-laden.
As noted, and not for the last time, the things that make us good at business—compliance, dealing with competitive pressures, managing technology—do not expand the affection and affinity in our relationships. Cynicism and survival drive out empathy, intensifying stress. Then the reverse commute back home; chauffeuring the kids around to activities such as soccer or play dates, to which they are entitled and which they require in order to become well-rounded, successful human beings; strained relationships with these very kids over homework and with the spouse over the lack of satisfying relatedness much less a sex life, and the drum beat of micro-stressors goes on. The formula for wide-spread chronic stress is complete.
Social stress enters the body through the immune system
The body responds to common bacterial infections and to wounds by becoming inflamed. How this works—and does not work—becomes a tadtechnical, and I have to ask the reader’s patience in laying out the distinctions needed to connect the dots between stress, inflammation, and empathy.
How does stress get into the body? This is important, because, when stress “gets in,” it sets off a cascade of negative results that affect our physical and emotional well-being. To cut to the chase, scientists believe that stress gets into the body through the immune system. (See the article by Segerstrom and Miller (2004) cited above and listed as a reference below.) Once stress activates immune processes designed to fight infection, the dominoes start falling. Diverse systems of the body can be left in a state of chronic inflammation, which, if left untreated, result in life style disorders and diseases.
These disorders include conditions such as irritable bowel syndrome (IBS), metabolic disorders (obesity, type 2 diabetes, congestive heart failure, chronic pulmonary obstructive disease), migraines and lower back pain (notoriously difficult to diagnose), and numerous allergies (peanut, gluten, lactose, dust) with which many children (and adults) now find their vitality reduced. (This list is not complete.)
The human immune system was developed between 100,000 and a million years ago when our early proto-human ancestors emerged on the plains of present-day East Africa. Now one must be on guard against generating a “just so” story about what life was like in such an early environment of evolutionary origin.
Our ancestors faced a different set of challenges than we do. If they wanted to get somewhere, they had to walk. If they wanted to do detailed work such as sewing after sunset, they had to light a fire. If they got sick, they had a choice of naturally occurring purgatives, stimulants, or a sweat lodge to try to sweat out the toxins. They were exposed to physical hazards in chasing game such as rabbits or antelope for food through the bush. Injuries such as cuts and abrasions were common; and when such injuries to the skin occurred, the risk of infection was significant. Responding to tissue damage had a priority. If a wound became infected, the entire organism was at risk. Mini-clinics had not yet been invented.
What the sick person experiences as the disease is actually the beneficial side-effect of the defense mounted by the body’s immune system against disease. Our bodies developed their built-in ability to heal wounds and respond to infections in this physically demanding environment. We are the beneficiaries of millennia of natural selection to protect the organism against wounds and infections—and, in addition, we now have mini-clinics and antibiotics.
The sick person experiences the disease as the body’s defense
The wound temporarily becomes red—it is inflamed—and the body sometimes becomes feverish in an attempt to kill the intruder by “cooking” it. As part of this defensive response, the body engages in “sick behavior.” It tends to withdraw; wants to lie down in its bed; experiences low energy; and has an increased need to sleep. Such behavior makes perfect sense in terms of rallying the body’s resources to overcome the disease.
The body summons defensive biological agents to the location of the injury. These defensive agents include macrophages—literally “big eaters”—that attack the foreign invaders and encompass and digest (i.e., eat) them. The body’s immune system gets into action and sounds the alarm using messengers called “cytokines.” “Cytokines” have become famous because an entire theory of depression is named after them. More on that shortly.
These Big Eaters—macrophages—and cytokines congregate at the site of injury or infection, release toxic substances such as oxygen radicals that damage invaders, and break down the invaders and damaged tissue. These defenses have broad effects on the organism, including fever and inflammation, as they promote wound healing.
Now take this immune system, which was developed to defend against wounds and bacteria, and fast forward about half a million years to our own time. Modern humans no longer face hostile animals and the elements. It is true that parts of our modern cities have become urban jungles, in which people behave in aggressive ways towards their neighbors; but the majority of the population still manages to avoid such situations, granted that is little consolation to those trapped in social injustice (itself a source of social stress).
Today human beings face social stressors as well as biological ones. Such social stressors are symbolic in that they represent non-material entities such as status, power, a piece of paper or electronic bits called “money,” expectations about the future, access to resources based on educational opportunities (or lack thereof), and meaning making of the kind we explored in world class novels and narratives from George Eliot (May Ann Evans), Thomas Mann, Tennessee Williams, and Shakespeare. Social status is a symbolic good. For our proto-human ancestors, social status in the group translated into access to choose morsels of food and access to superior mating opportunities. Likewise, with us?
For us moderns the symbolic stress now has become chronic and unremitting. It is not that life as such was so much better when the vast majority of the population worked on a farm (or were hunter-gatherers). Let us not idealize the past. Days were long—from sunrise to sunset (since electricity had not been invented). Life was surely physically harder. Disease was not a symbolic threat; it was an ever-present danger and immediately present. Death was a daily companion and a near, not a remote, possibility.
Still, expectations were probably lower. Resignation and acceptance of one’s fate were embedded more deeply. People were too physically exhausted to worry about whether one’s child would get into a preschool program that would enable her to qualify for Harvard. Perhaps that itself provided relief from chronic stress.
If one lived even a hundred years ago, the likelihood was that, if one survived the hazards of childhood, an infectious disease such as influenza, tuberculosis, cholera, or pneumonia would eventually end one’s life. Childhood mortality and death in childbirth were major factors limiting life expectancy; though if one survived childhood, then one’s life expectancy as an adult might approach that which we enjoy today in developed countries with modern medicine.
The good news is sometimes also the less good news. Today thanks to antibiotics and vaccinations, the vast majority of the population in developed countries survives long enough to develop chronic disorders associated with social stress and life style responses to it.
In the final part of this series, we look in detail at the dots connecting the stress and inflammation reducing properties of empathy with improved well-being and evidence based outcomes in basic medicine. Stand by!
[i] Suzanne C. Segerstrom and Gregory E. Miller. (2004). Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry, Psychol Bulletin, 2004 July, 130(4): 601–630.
[ii] Bessel van der Kolk. (2014). The Body Keeps the Score: Mind, Brain and Body in the Trans- formation of Trauma. New York: Penguin Books.
Note: All the usual disclaimers apply. This is not intended to be, nor is it, medical advice or medical guidelines. Always consult with your medical doctor and other professional counselors about decisions affecting your health and well-being.
Image Credit: Group Tai Chi practice in a Shanghai park led by Grandmaster Xie Bingcan in 2011. Author: Seattletaijiquan This file is licensed under the Creative Commons Attribution-Share Alike 4.0 International license
(c) Lou Agosta, PhD and the Chicago Empathy Project
Edwin Rutsch interviews Lou Agosta: Empathy Curriculum: Overview of the Empathy Lessons Training Seminar (ETLS)
Empathy Curriculum: Overview of the Empathy Lessons Training Seminar (ELTS): Edwin Rutsch interviews Lou Agosta about the ELTS and Lou’s experiences around empathy
To listen to Edwin’s Rutsch’s interview and conversation with Lou Agosta on Sept 1, 2026.
Play interview by clicking
here: Edwin Rutsch Interviews Lou Agosta
[ https://youtu.be/4jQe9ccVfM8?si=lwVibcPIN8D67v3w]
The following summary was generated by AI by Edwin Rutsch.
Edwin Rutsch interviews philosopher, author, and clinical assistant professor Lou Agosta to explore his 10-week “Empathy Lessons Training Seminar.” The discussion covers the philosophical foundations of empathy, its physiological benefits, methods for diagnosing and repairing empathy breakdowns, and the role of rigorous boundary setting.
“Empathy isn’t drowning in the other person’s ocean of misery – it’s taking a six-ounce pour of their suffering so you can truly understand it without losing yourself.”
10 Week Training Outline
- Session One: The one-minute empathy training
- Session Two: Empathy and brain science – this is your brain on empathy
- Session Three: Empathy breakdowns, breakthroughs and introspection
- Session Four: Resistance to empathy
- Session Five: The Secret underground history of empathy
- Session Six: Empathy and story telling
- Session Seven: Empathy and boundary setting
- Session Eight: Review of the literature that empathy is good for one’s health and well being
- Session Nine: Speaking truth to power – rhetorical empathy in politics
- Session Ten: Empathy is the new love – examining love through empathy
This interview series is part of The Empathy Center’s initiative to develop an open-source Empathy Movement Training Curriculum.Join us in creating it.
Short Meeting Overview
Edwin Rutsch interviews philosopher, author, and clinical assistant professor Lou Agosta to explore his 10-week “Empathy Lessons Training Seminar.” The discussion covers the philosophical foundations of empathy, its physiological benefits in healthcare, methods for diagnosing and repairing empathy breakdowns, and the role of rigorous boundary setting.
Paragraph Meeting Overview
This meeting serves as the inaugural interview in an exploratory series for the Empathy Movement Training Curriculum project, led by Edwin Rutsch, Founding Director of The Empathy Center. Guest Lou Agosta outlines the architecture of his upcoming 10-week training seminar, unpacking a multidimensional definition of empathy that spans receptivity, understanding of possibility, perspective taking, and empathic responsiveness. Agosta shares how his personal background, academic work at the University of Chicago under Heinz Kohut’s circle, and clinical teaching at Ross University Medical School informed his model of a “rigorous and critical empathy.” The dialogue bridges psychological theory and real-world application, detailing how stress reduction, mirror neurons, and repairing empathy breakdowns (e.g., emotional contagion, projection) enable human connection. Finally, both dialogue partners investigate movement-building strategies, discussing the need to articulate the societal value of empathy, embrace assertive public presence (such as the Empathy Tent and potential legislative sit-ins), and synthesize diverse empathy pedagogies into a collaborative, open-source curriculum.
Step-by-Step Outline of the Discussion
1. Introductions and Seminar Overview
- Time code: [00:02] – [05:46]
- Core Discussion Points:
- Edwin introduces Lou Agosta (author of A Rumor of Empathyand Empathy and Morality) and frames the interview within the Empathy Movement Training Curriculum initiative.
- Lou introduces his background: PhD from the University of Chicago, clinical assistant professor of psychiatry at Ross University Medical School / St. Anthony Hospital in Chicago.
- Lou highlights peer-reviewed clinical research demonstrating that physician empathy measurably improves patient outcomes (e.g., lower cholesterol, improved diabetes markers, reduced stress/inflammation).
- Outcome: Established the academic, clinical, and practical premise of the 10-week Empathy Lessons Training Seminar.
2. Defining Empathy and Philosophical Foundations
- Time code: [05:46] – [13:14]
- Core Discussion Points:
- Lou details the four core aspects of empathy: Receptivity (affective input), Understanding Possibility (recognizing who the person is beyond breakdown), Cognitive Perspective Taking (viewpoint), and Empathic Responsiveness (giving back what was heard for validation).
- Empathy Circles are acknowledged as a foundational gateway practice.
- Lou offers his central philosophical thesis: without empathy, there is no shared humanity (“the zombie apocalypse”). In parenting, teaching, medicine, and business, the other person calls forth the empathy in us.
- Outcome: Grounded the curriculum definition in a four-part relational process rather than a static trait.
3. Theory of Change and Overcoming Empathy Breakdowns
- Time code: [13:14] – [20:25]
- Core Discussion Points:
- Lou presents his “one-minute empathy training”: drive out aggression, bullying, prejudice, and negative politics, allowing empathy to expand naturally.
- Lou argues that “there is enough empathy to go around,” drawing an analogy to global food production (Norman Borlaug and the Green Revolution)-starvation and empathy deficits occur because resources are withheld, weaponized, or blocked.
- Outcome: Framed empathy development around clearing obstacles and blocks rather than manufacturing a scarce resource.
4. Personal Origins, Heinz Kohut, and Rigorous Empathy
- Time code: [20:25] – [33:20]
- Core Discussion Points:
- Lou shares the personal roots of his work: receiving bedtime storytelling empathy from his mother while dealing with a harsh, “boot camp” father.
- Studies at the University of Chicago during the rise of Heinz Kohut’s self psychology; working with colleagues Michael Basch, Arnold Goldberg, and Ernest Wolf.
- Defining “rigorous and critical empathy” (concept from Xavier Remy) as disciplined receptivity, interpretation, and responsiveness rather than sentimental (“kumbaya”) agreement.
- Being deeply listened to (by mentors, his mother, early partners, and psychoanalysts) demonstrated empathy’s life-altering impact.
- Outcome: Connected self-psychology lineage and experiential childhood background to the necessity of structured empathy training.
5. Course Structure, Safety, and Stress Reduction
- Time code: [33:20] – [38:59]
- Core Discussion Points:
- Overview of the course audience: broad applicability for leaders, mediators, educators, and anyone wanting to strengthen their “empathy muscle.”
- The seminar covers approximately 40 distinct empathy lessons across 10 two-hour sessions.
- Theory of change: “Transformation is instantaneous; change is hard work.” Empathy operates as a stress-reduction mechanism-getting heard is “like sinking into a hot bath” (quoting Kohut).
- Establishing safety through explicit agreements and confidentiality so participants can explore vulnerabilities without feeling forced to share.
- Outcome: Defined the seminar pedagogy as alternating 15-20 minute lectures with experiential sharing in a secure environment.
6. Walkthrough of the 10 Sessions (Part 1: Sessions 1-5)
- Time code: [38:59] – [58:49]
- Core Discussion Points:
- Session 1 (Definitions & Mind Reading): Exploring empathic receptivity vs. “mind misreading” (e.g., domestic arguments over toothpaste caps taking on distorted emotional meanings).
- Session 2 (Brain Science): Mirror neurons, stress pathways, and empathy as a non-pharmacological health intervention.
- Session 3 (Empathy Breakdowns): Four primary breakdowns-emotional contagion, conformity, projection, and communication loss. Emphasizing self-empathy as the foundation for repairing breakdowns.
- Session 4 (Resistance & Boundary Setting):Differentiating empathy from empathic distress/burnout. Critiquing Paul Bloom’s Against Empathy, arguing for both empathy and rational compassion. Taking a “six-ounce pour” (data sample) rather than drowning in someone else’s misery.
- Session 5 (Underground History & Aesthetics): Tracing empathy (Einf�hlung) from 19th-century German aesthetics and art history to psychology. Viewing people with the same reverence and care given to masterpieces.
- Outcome: Systematized the first half of the curriculum around scientific mechanisms, psychological pitfalls, and historical roots.
7. Walkthrough of the 10 Sessions (Part 2: Sessions 6-10)
- Time code: [58:49] – [01:13:00]
- Core Discussion Points:
- Session 6 (Storytelling & Spirituality): Exploring empathy through narrative (e.g., the Good Samaritan) and managing the vulnerabilities of the “natural empath.”
- Session 7 (Boundaries & Humor): Distinguishing healthy fences with gates from impassable walls (referencing Robert Frost). Examining how humor discharges tension through boundary-crossing, contrasting aggressive wit with respectful empathy.
- Session 8 (Trainability & Social Healing): Evidence showing empathy is a trainable skill; empathy as an essential social survival tool (“wear a parachute, use penicillin, lead with empathy”).
- Session 9 (Rhetorical Empathy & Speaking): Moving beyond empathic listening into empathic speaking and speaking truth to power. Analyzing Malcolm X (“Plymouth rock landed on you”), Abraham Lincoln, and Barack Obama.
- Session 10 (Empathy and Love / Racism): Examining the spectrum between soothing empathy and “tough love,” reflecting on Edwin’s dialogues with former extremists and Daryl Davis.
- Outcome: Completed the comprehensive overview of the 10 sessions, emphasizing expressive/rhetorical empathy and tough love.
8. Movement Building, Value Perception, and “Occupy Empathy”
- Time code: [01:13:00] – [01:22:30]
- Core Discussion Points:
- Gaps in the empathy ecosystem: Practitioners often hesitate to articulate the monetary and societal value of empathy. While empathy is a common good like clean air or water, professional empathy instruction must be valued.
- Reframing interpersonal conflict: Approaching difficult colleagues, challenging customers, or provocative relatives as one’s personal “empathy trainers.”
- Edwin’s proposal for “Occupy Empathy”: Expanding the Empathy Tent model from street fairs and political rallies to sustained public demonstrations (e.g., occupying legislative capitols until politicians engage in Empathy Circles). Lou expresses enthusiasm and willingness to support public actions.
- Outcome: Concluded with mutual appreciation and an agreement to collaborate on public empathy activism and curriculum development.
Empathy Movement Curriculum Insights
Mapping the concepts from this interview directly to the development modules of the Empathy Movement Curriculum
- Module 4: Definition of Empathy
- Four-Phase Model: Incorporate Lou’s four distinct phases into the curriculum:
- (1) Receptivity (mammalian affective communication),
- (2) Seeing the Person as Possibility,
- (3) Cognitive Perspective Taking, and
- (4) Empathic Responsiveness (testing accuracy: “Did I get it right?”).
- Abundance vs. Scarcity: Adopt the pedagogical stance that empathy is not inherently scarce; like food in the Green Revolution, there is enough to go around. Training should focus on removing systemic and psychological obstacles (aggression, prejudice, bullying) rather than treating empathy as an artificial commodity.
- Four-Phase Model: Incorporate Lou’s four distinct phases into the curriculum:
- Module 5: Deeper Empathy (Carl Rogers, Self Psychology, & Diagnostics)
- Heinz Kohut�s “Hot Bath”: Use the clinical framing that receiving genuine active listening lowers biological stress and soothes the nervous system, functioning as a primary non-pharmacological health intervention.
- Rigorous & Critical Empathy vs. Over-Identification:Teach boundary management via the “six-ounce pour”metaphor. Empathy is data sampling of another person�s experience, not merging or drowning in their distress. This provides facilitators with protection against compassion fatigue.
- Self-Empathy as Breakdown Repair: Embed exercises where participants identify personal triggers (e.g., emotional contagion, projection) and listen to their own internal reactions before attempting to reflect or engage with an external counterpart.
- Module 7: Conflict Resolution & Depolarization
- “Mind Reading” vs. “Mind Misreading”: Design exercises identifying how minor conflicts (e.g., toothpaste caps, household chores) get distorted into existential accusations (“You don’t love me”). Learning to de-escalate involves separating literal content from invented meaning.
- The “Empathy Trainer” Reframe: Train participants to view difficult coworkers, contentious family members, or ideological opponents not as adversaries, but as high-leverage “empathy trainers” for practicing active listening.
- Tough Love Spectrum: Position Empathy Circles along a developmental continuum that includes soothing listening on one end and assertive, boundaried “tough love” on the other when engaging with manipulative or bad-faith actors.
- Curriculum Innovation: Rhetorical Empathy (Empathic Speaking)
- Speaking Truth with Empathy: Expand the curriculum beyond active listening into empathic speaking (Session 9 in Lou�s seminar). Use historical examples (Malcolm X, Lincoln, Obama) to demonstrate how speakers validate audience experiences and cultural metaphors while delivering transformative, challenging truths.
- Movement Building & Public Activism (Occupy Empathy)
- Assertive Action (“Occupy Empathy”): Move beyond passive workshops by taking the Empathy Tent into high-stakes civic arenas. Establish direct-action campaigns (e.g., state capitols, public plazas) facilitating structured Empathy Circles between polarized political factions.
- Articulating Societal & Economic Value: Overcome reluctance around financial valuation. Empathy advocates must clearly articulate the tangible return on investment of empathy training in healthcare, business, and civic life.
- (c) Edwin Rutsch and the Culture of Empathy and Lou Agosta, PhD and the Chicago Empathy Project
Registration now open: Empathy Lessons Training Seminar (ELTS) Registration, Syllabus, Agreements
Empathy is oxygen for the soul. Short of breath? Maybe one needs expanded empathy. Get some empathy and expand yours in this seminar. A rigorous and critical empathy says: I know what you feel because I feel it, too, as a vicarious experience, not a merger. It is not as if parents, teachers, doctors, therapists, friends, and neighbors, needed an expert to tell them what empathy is. Ask any parent, teacher, behavioral health professional, and they practice empathy every day, even if they may not always be able to say it out loud. This seminar brings forth what you already know about empathy – what you have already learned since you could not survive without empathy – and expands it with abundant tips, techniques, and real-world transformation in exercising empathy as a power and practice.
A detailed outline (syllabus) of the seminar, benefits you will obtain by participating, and agreements for participants follow inline.
Here is how to register: click below (ELTS):
Empathy Lessons Training Seminar Syllabus Outline – this is the outline of the seminar
Empathy Lessons Training Seminar (ELTS)
Empathy is oxygen for the soul. Short of breath? Maybe one needs expanded empathy. Get some in this seminar: I know what you feel because I feel it, too, as a vicarious experience, not a merger. It is not as if parents, teachers, doctors, therapists, friends, and neighbors, needed an expert to tell them what empathy is. Ask any parent, teacher, behavioral health professional, and they practice empathy every day, even if they may work on how explicitly to bring forth what they know. This seminar brings forth what you already know about empathy – and expands it with abundant tips, techniques, and real-world transformation in exercising empathy as a power and practice.
Schedule: Every Saturday for ten weeks Sept 12, 2026 thru Nov 21, 2026 at 11 am CDT – starts after Labor Day (USA) and ends before Thanksgiving (USA) via Zoom
Seminar Syllabus Outline:
Session One: The one-minute empathy training.
Talking points:
- Personal note: The beginning of my empathy training
- The multi-dimensional definition of empathy
- Empathic receptivity and vicarious experience
- Empathic understanding—understanding of possibility
- Where there is “mind reading” there is “mind misreading”
- The folk interpretation of empathy: Top-down empathy
- There is enough empathy to go around, even though it does not seem that way on most days. Why is that?
Session Two: Empathy and brain science – this is your brain on empathy
Talking points:
- Mirror neurons – what are those?
- Stress and inflammation: Some is good, too much is not
- Social stress enters the body through the immune system
- Connecting the dots: stress and inflammation
- Connecting the dots: anti-inflammation and empathy
- Empathy as a “Miracle drug”
- Empathy is a spa treatment for the soul
Session Three: Empathy breakdowns and introspection
Talking points:
- Emotional contagion is failed empathy
- The analogy of optical illusions with empathy breakdowns
- Empathic receptivity breaks down as emotional contagion
- Empathic understanding breaks down as conformity
- Empathic interpretation breaks down as projection
- Empathic response breaks down and gets “lost in translation”
- Introspection is the royal road to empathy; be introspective
Session Four: Resistance to empathy
Talking points:
- Overcome resistance to empathy, and empathy expands
- Train and develop empathy by overcoming the obstacles to empathy
- “Listen from possibility” rather than listening from a “position X”:
- Distinguish between what happened and what one made it mean
- Empathy is a tuner or dial, not an “on-off” switch
- Empathy is a method of data gathering about the other person:
- Be generous with acknowledgement
Session Five: The Secret underground history of empathy
Talking points:
The distinction “empathy” was a part of sympathy, fellow feeling, vicarious feeling, communicability of affect in aesthetics and art history, and storytelling is discussed through different methods of inquiry. The session includes short selections from the philosophers, phenomenologists, and psychoanalysts
- David Hume,
- Immanuel Kant,
- Theodor Lipps,
- Sigmund Freud,
- Heinz Kohut,
- Husserl/Edith Stein,
- Max Scheler
Session Six: Empathy and story telling
Talking points:
And, yes, we are going to tell some stories.
- The “Natural Empath”: Caught between nature and nurture
- The Good Samaritan meets the Natural Empath
Examples of empathy from World Literature including
- Toni Morrison
- George Eliot (Marion Evans)
- Thomas Mann
- Albert Camus
- Goethe
Session Seven: Empathy and boundary setting
Talking points:
- Get your power back through empathy
- Establish and maintain firm boundaries between the self and the Other in relating empathically – but do not forget to practice being inclusive
- Empathy deescalates anger and rage
- Empathy is the ultimate anti-bullying anti-dote –
- When (why) empathy doesn’t work with bullies, psychopaths, and the criminally insane – and what to do about it
- Empathy is closely related to humor
- Empathy lessons are everywhere
Session Eight: Review of the literature that empathy is good for one’s health and well being
Talking points:
- Empathy is trainable – practice, you get better at it
- The empathy exams
- What counts as evidence that empathy works?
- Evidence-based empathy
- Jumping out of an airplane – be sure to wear a parachute
- Common factor, empathy, in social healing practices
Session Nine: Speaking truth to power – rhetorical empathy in politics
Talking points:
- Truth versus politics
- The first instance of fake news—ever
- Empathic receptivity soothes anger and rage
- Empathic understanding discloses political vision
- Empathic interpretation engages intractable problems
- Rhetorical empathy: Empathic responsiveness
- Malcolm-X’s rhetorical empathy
- John Stuart Mill’s rhetorical empathy
- Governor Altgeld’s rhetorical empathy
- Ronald Regan’s rhetorical empathy
- Lincoln’s rhetorical empathy
Session Ten: Empathy is the new love – examining love through the lens of empathy
Talking points: So If empathy is the new love, what then was the old love?
- Defining Our Terms: Love and Empathy
- Empathy and love have characteristic breakdowns
- The unbearable lightness of empathy
- Design defects of the male brain
- Women and men want the same things—but differ in priority
- The desire of desire
- The Positive Aspects of Love as Empathic Relatedness
- From Death in Venice (a story) to Empathy in Venice
- Love as a boundary issue: Empathy as a soothing balm
Top Benefits of the Empathy Lessons Training Seminar – these are the benefits –
The answer is empathy – so what’s the question? Stress pushes people down into survival. People stress other people, being difficult to deal with at home, on the job, in school, or at leisure with friends. In the Empathy Lessons Training Seminar (ELTS) the participants get an opportunity to engage directly the obstacles that stopping them from getting the empathy. Participants acquire the empathic responsiveness needed to experience satisfaction in relationships of all kinds, personal and professional. Participants overcome the obstacles to effective relationships and shift out of survival mode and into empathic responsiveness in which fulfillment and satisfaction occur that did not previously seem possible.
The top benefits of the empathy lessons training seminar that the participant will receive include expanded empathy and –
1. reduced conflict in one’s life and one’s organization, reducing dignity violations, shame, and related anger and rage
2. expanded power and freedom in the face of resistance, no agreement, or bullying
3. reduced time to results in personal and professional projects, expanding teamwork
4. expanded listening one other individuals and to oneself
5. expanded results in personal relationships
6. reduced compassion fatigue, burnout, professional cynicism or denial
7. expanded cooperation in one’s personal and professional relations, increasing satisfaction with one’s individual and organizational goals
8. the ability to be with another person no matter how difficult an individual
9. the ability to distinguish what happened from what one made it mean
10. ability to like people and be with people regardless of background
11. distinguishing empathy effectively from compassion, altruism, and charity (they are not the same!)
12. the ability to recognize and acknowledge the humanness in oneself and others even in extreme situations
13. the ability to set boundaries in relatedness and navigate boundaries with finesse and skill – for example, in dealing with bullies
14. the ability to shift your empathy from being an “on off” switch to being a rheostat that dials empathy up and down as a filter
15. expanded humor, creativity, appreciation of art, and wisdom – all closely related to empathy – relationships, teamwork, and leadership
Also note:
Participants will get the most value from attending all the sessions. However, for those with scheduling challenges, it is not required to attend every session because every session (except the first) contains a short upfront review of terms and what the participant needs to know to get value from the work.
The Empathy Lessons Training Seminar [ELTS] may be delivered as a stand-alone ten session class for participants who register individually. Alternatively, the ELTS may be delivered as part of an empathy consulting engagement. The organization’s team members are separately interviewed, confidential feedback aggregated anonymously and presented to the leadership, and group work on problem solving, conflict resolutions, issue handling, proceeds in parallel with large group work and small group breakout sessions under the guidance of the organization’s leadership.
The benefits of the ELTS are most available to participants who attend all the sessions. People may selectively attend one or more session and still obtain significant benefit. Naturally, attending more sessions will result in expanded benefits. Whatever you do you are going to get empathy, and, no surprises here, you get out of it what you put into it.
Empathy Lessons Training Seminar (ELTS) Agreements
The Empathy Training Seminar (ELTS) is delivered through Alleingang, Inc., an Illinois Chapter C corporation, Lou Agosta, PhD, President, responsible for providing diverse services in education, consulting, and publishing. The trainer is Lou Agosta. The participants are the individuals who sign up, pay the fee, agreement to these agreements (hereafter: Agreements) and attend the training.
The ELTS is a ten session, structured conversation designed to expand empathy in the participant and in the community. The ELTS occurs as a two-hour session for ten weeks for a total of some twenty hours.
The ELTS training material distributed to the participants is copy-righted material and the conversations that occurs in the seminar are confidential and for the personal use of the participants. It may not be recorded, copied, taped or otherwise captured to electronic media. Any notes taken by the participants are only for the personal use of the participants and may not be published, sold, or otherwise redistributed under any circumstances.
The ELTS is committed to creating an environment where people have the freedom to express themselves and participate without restrictions. Therefore, the ELTS requests that you keep the names and details of what people say in the ELTS confidential. Participants will be separately asked to sign a document in which the person agrees to keep the names and details of what people say in the ELTS confidential, and such signature is a requirement for participating in the ELTS.
Further detailed agreements and background are specified in the online agreement document. The person considering participating is asked to review all these additional agreements carefully, let the trainer (LouAgosta@gmail.com) know of any questions or concerns, and agree to the agreements in completing the registration process.
Consistent with good business practices and current law, Alleingang, Inc. does not tolerate sexual harassment or other forms of harassment in any of our training programs or events. If you have any questions about our policies regarding sexual or other forms of harassment, please contact Lou Agosta (773-203-0269).
The participant hereby agrees to (in the following “I” – “my” – and so on refer to the participant):
- To be on time for my sessions as scheduled
- To discuss and say what is on my mind and what is going on in my life without editing or holding back – to just tell the truth
- Same idea as above – to be straight about what I am thinking and feeling – regardless of its significance or lack of significance to me or even if seems embarrassing or trivial
- If I have an emergency (for example, serious illness, life event, two feet of snow), then I will communicate as soon as I know about it
- If I have a complaint, concern, or issue with the empathy consultant or with the process of training, then I will come into my session and talk about it to resolve it
- I understand that on occasion empathy consulting requires me to consider and discuss confronting and difficult personal matters, including but not limited to my own behavior, blind spots, and thoughts
- To pay the fee agreed upon for the ELTS with the understanding that it is nonrefundable
- To pay the fee agreed upon for the ELTS with the understanding that it is nonrefundable, though in the event of an authentic emergency a reasonable effort will be made to include the participant in a similar (“substitute”) future session
- To be responsible for my health and well-being at all times, in participating in this work
I acknowledge that our conversation and the ELTS are confidential and have received this written statement of confidentiality. Exceptions to confidentiality include [but are not limited to] if the trainer believes the participant is hurting or plans to hurt her- or himself or another person, for example, requiring summoning emergency [911] services. Then confidentiality would not apply.
By entering one’s name and date and related identifying data on the separately published ELTS form, the participant agrees to the Agreements
Here is how to register: click below (ELTS):

Image Credit: photo by Alex Zonis of Lou Agosta, PhD making a presentation on the Secret Underground History of Empathy on November 13, 2015 at a local Chicago adult education program.
(c) Lou Agosta, PhD and the Chicago Empathy Project
Empathy lesson: Take the other person as your empathy trainer
As an exercise, consider that the other person is one’s empathy trainer. The other individual calls forth one’s empathy. If the Other behaves in a challenging way, the challenge is to one’s empathy. If the other person is in an emotional meltdown, the challenge is to one’s empathic receptivity. If the other person is a conformist, the challenge is to one’s empathic understanding.
Listen to this blog post as a podcast. (There may be minor differences in phrasing between the written and spoken versions as this is not a transcript.)
If the other person is accusatory, projecting hostility, or just hard to figure out, the challenge is to one’s empathic interpretation. If the other person’s self-expression is lost in translation, the challenge is to one’s empathic responsiveness.
If the Other is a difficult individual, the challenge is to one’s empathic relatedness. This gives new meaning to the empathy exams. Think of the “secret shopper,” who tests the sales person’s customer service skills, even if the test is just to set boundaries.
This business of taking the other person as one’s empathy trainer is an indirect reference to a wonderful essay (really a memoire-like story) by Leslie Jamison entitled, “The Empathy Exams,” by which this conversation is inspired, is about Jamison’s experiences working as a medical actor. [i] A medical actor is a person who is hired by a medical school to learn a script. The medical actor portrays a person who has a particular disease. Jamison’s narrative about her work as a medical actor is humorously (and movingly) interwoven with an illness of her own with which she is suddenly confronted.
The medical actor’s script contains instructions: “Your first line is: ‘I’m having these seizures and no one knows why’.” The backstory in the script, which the actor must memorize, is that there is nothing physically wrong with the patient. She has a hysterical personality disorder.
The medical student being examined is graded on how close he or she comes to “nailing” the diagnosis through diagnostic questioning. However, more to the point here, the exam is about whether the medical student’s manner of interacting with the patient is warm, cold, energetic, apathetic, authoritarian, indifferent—or empathic.
The empathy exam is included as part of the feedback provided by the medical actor that goes to form the medical student’s grade. Examining someone—giving a person a test—on something implies that the result can be improved by, training, feedback and practice. One looks for areas for improvement—that is the point of education.
The empathy exams that medical students take are a reality. But even before these real-world empathy exams, a celebrated science fiction novella included an empathy exam. A masterpiece ahead of its time, Philip K. Dick’s negative fantasy of the future Do Androids Dream of Electric Sheep (1968) received widespread coverage when made into the movie Blade Runner (1982), starring the young Harrison Ford as the bounty hunter, anti-hero, Rick Deckard. [ii]
In Dick’s celebrated novella, six bioengineered replicants (robots), who are virtually indistinguishable from human beings, have escaped from their assigned location on Mars. They have returned to Earth in an attempt to find their designer, and, force him to postpone their auto-destruction coding. They do not want to be retired—that is, they do not want to have to die. What is the one difference between humans and replicants? The replicants lack empathy.
In the context of the narrative, empathy is detectable by an empathy test, the “Voight-Kampff exam.” No such exam exists. This fictional exam uses a mechanism that is similar to a lie detector as it captures physiological data in response to empathy inspiring questions. For example: “You see a tortoise on its back in the hot sun with its legs flailing helplessly in the air. It cannot turn over without your help. How do you feel?” Or “A little boy shows you his butterfly collection plus the killing jar. What do you feel? What do you say?”
If the individual being interviewed (suspected of being a replicant) produces particular responses—accelerating respiration, blush, heart rate, eye movement, galvanic skin response—then empathy is present. The interviewee is human, not replicant.
Now the narrative twist that elevates Dick’s story above the average science fiction yarn is that, as the story unfolds, the humans become less empathic and the replicants more so. The replicants make a contribution to the community, are altruistic and socially useful, whereas the bounty hunter, who is trying to “retire” them, behaves increasingly aggressively, selfishly, manipulatively, anti-socially, even psychopathically. His conscience and his empathy are in retreat.
What is limiting about Dick’s otherwise visionary account of empathy is that the protagonist and other characters in the narrative believe that empathy is invariable. You either have it or you don’t. However, the development of the plot provides evidence that exactly the contrary is the case. Empathy expands in one case, contracts in another.
Rick Deckard starts out as a human with nuanced emotions. But as he continues killing in his role as bounty hunter, he becomes less empathic, more and more hard-hearted. The replicants, who are attempting to flee from their fate, behave with expanded empathy—and humanity.
The powerful irony is that the replicants end up being more human than the humans. In spite of what some people may believe, based on practices and actions, a person’s empathy expands—or shrinks. This is further evidence that empathy is trainable – one training tip and technique is to take the other person – regard the other person – as one’s empathy trainer.
Now let us take a step back and continue to engage with the empathy lesson. This approach is generalizable. “In any encounter with another, consider the other person as one’s empathy trainer.” The newborn baby trains the parent in how to be empathic; the student trains the teacher; the patient, the doctor; the client, the consultant; the customer, the business person selling the product or service; the neighbor, the stranger; and the audience, the speaker.
This may sound backward and paradoxical. However, by standing things on their head—the customer trains the business person in empathy, the student trains the teacher in empathy, the infant trains the parent in empathy and so on—we get a surprisingly refreshing view of how empathy makes a difference. The survivor is rescued by the Good Samaritan; but the Samaritan is humanized by—gets his humanity from—the survivor, even in addressing the survivor’s temporary loss of humanity as a suffering lump of battered flesh. The baby, the student, the patient, the customer, the neighbor, are the individuals who bring empathy into existence for the parent, the teacher, the business person, the neighbor, respectively.
Note this give new meaning to the term “dialectical” as in Marsha Linehan’s innovative treatment of Dialectical Behavioral Therapy (DBT). “Dialectical” refers to an apparent contradiction – the baby trains the parent, the customer trains the business person – which upon examination is actually a breakthrough in relatedness.
Without the baby, there is no parent. Without the parent, there is no empathy with the baby. The baby calls forth the parent’s spontaneous and natural empathy. The baby creates a clearing for parenting to show up as empathic or non-empathic or something in-between.
Without the customer, there is no business or business person. Without the business person, there is no empathy with the customer. The customer calls forth the business person’s natural and spontaneous empathy. The customer creates a clearing for the encounter with the business to show up as empathic or non-empathic or something in between.
Without the patient, there is no medical practice or medical doctoring. Without the MD, there is not empathy with the patient. The patient calls forth the MD’s natural and spontaneous empathy. The patient creates the clearing for the encounter with the doctor to show up as empathic or non-empathic or something in-between. Likewise, with the teacher and student, client and consultant, and neighors in the community.
However, surely the baby does not give a lecture with a Power Point. The baby needs to be on the receiving end of empathy before she or he can develop an ability to be empathic in an intentional way towards anyone else.
Though the empathic sensitivity of children should not be under-estimated, this is an important consideration. We must be recipients of our parents’ and care-takers’ empathy before we are able to turn around and provide empathy to Others, even as we practice empathy in immature, emerging, and developing ways as we grow up.
Yet even without being self-aware, the baby provides an opportunity and possibility for the parents’ empathy lessons. The baby provides a clearing for empathy lessons for the parents even without meaning to do so. The baby creates the possibility of empathic parenting by the baby’s readiness to become human, which at first shows up as a distinct lack of socialization. The baby cannot feed itself and empties its processed waste into its diapers.
The parent socializes the baby; the baby humanizes the parent, calling the parent not just to its role as parent (though it does that too), but also to its possibility as a human being in a committed relationship to another emerging human (the baby) through trial and error. The baby, by its very existence, gives the parent his humanness, making the parent into an inquirer into what it is to grow up, developing from an immature baby into an adult human.[iii]
Likewise, with the business customer: The customer does not tell the business owner, “I have a need but can’t explain it to you.” Instead, the customer just keeps shopping around. The customer does not tell the business person, “I have a complaint about the service, and I want you to listen to it and make amends.” Instead, the customer just takes his business to the competition.
In each case, the empathy lesson is a challenge to the would-be parent, teacher, sales person, consultant, therapist, nurse, attorney, taxi driver, neighbor, and so on, to expand one’s receptivity, enhance one’s grasp of the possibilities, appreciative different points of view, and practice rapid empathic response.
If each of these persons—parent, teacher, business person, neighbor, and so on—begin in any other way than with empathy, they are headed for trouble. The challenge is straightforward: expand one’s listening to include the other individual in the empathic community or fall back into empathic distress; relate from possibility or get mired in stuckness; work on building community or wander aimlessly in the emotional wilderness.

Episode art photo credit: David Axelrod interviews (confronts, debates, talks to) Senator Tom Cotton June 2, 2017 in a photo taken by Lou Agosta at the University of Chicago public debate. As one of the architects of Barack Obama’s presidential program, Ax (as he is affectionately known) would be likely to disagree with many of Senator Cotton’s more-or-less MAGA-oriented views. Take the other person as your empathy trainer! I believe both did!
(c) Lou Agosta, PhD and the Chicago Empathy Project
Notes
[i] Leslie Jamison. (2014). The empathy exams in The Empathy Exams: Essays. Minneapolis: Graywolf Press: 1–27.
[ii] Philip K. Dick. (1968). Do Androids Dream of Electric Sheep? New York: Ballentine Books, 1981.
[iii] Lou Agosta. (2010). Empathy in the Context of Philosophy. London: Palgrave: 60–61.
(c) Lou Agosta, PhD and the Chicago Empathy Project
Empathy SELLS – but empathy’s limitations sell even better
As a popular trend, empathy peaked in 2009 with the publication of the late Franz de Waal’s now classic The Age of Empathy. De Waal goes on to profile “Our kinder, gentler [Bonobo ape] ancestors” on Oct 3, 2009 in the middle column of the then largely still hardcopy Wall Street Journal,” casting doubt on the “killer instincts” of our early humanoid ancestors. De Waal’s essay champions the position that this aggressive and over-sexed species, human beings (homosapiens), is capable of empathy, compassion, altruism, gratitude, generosity, and such “pro social” attitudes. Fast forward a decade and a half.
Listen to this podcast on Spotify:
https://open.spotify.com/episode/5H74frDb1M8df58c9IjddG?si=Mp1D99JoTxyfCsQYm1ItkQ
Empathy still sells and is honored and advocated as a powerful intervention to deescalate aggression and conflict. A rigorous and critical empathy still champions the many successful applications of tough love, red teaming, hard empathy, and limit setting while acknowledging the limitations and the ways that empathy can break down, including phenomena such as emotional contagion, projection, conformity, messages getting lost in translations, in the trials and errors of being empathic. A rigorous and critical empathy is committed to doing the hard work of overcoming these break downs and misfirings in order to relate authentically and in integrity to the other individuals and the community.
But if empathy still sells, its limitations sell even better. The latest trend is to denounce empathy as a weakness and a danger to western civilization. Gad Saad’s Suicidal Empathy (2025) goes further than the initial wave of anti-empathy advocates such as Paul Bloom (2016), Fritz Breithaupt (2017), Glenda Carpio (2023), and Namwali Serpall (2019). With Saad, the recommendation is not that one should apply rational compassion rather than empathy (Bloom) or deploy “enlarged thinking” (Carpio “channeling” Hannah Arendt) instead of empathy or that empathy is a kind of “slave morality” masquerading as kindness (Breithaupt). Rather “empathy” should be added to the list of “pro social” characteristics such as altruism, compassion, charity, generosity, gratitude, helping those in need, being kind to animals, turning the other cheek, and so on (even though empathy is not an emotion as such but a form of emotional communication among other things). Throw them all under the bus. Being kind makes you and your community a sucker, and as P.T. Barnum, the founder of the Ringling Brothers and Barnum & Bailey Circus, famously noted, “There is a sucker born every minute.”
The anti-empathic advocates offer a thought experiment: If you are in an overcrowded life boat after your ship sank, then taking on further survivors may cause the boat to sink, and everyone will perish. Don’t be an empathic sucker; push the competition under. If you do not do so, you are at risk of (drum roll): suicidal empathy.
What is overlooked is that this “thought experiment” is a set-up and is a double bind. Given the rock and the hard place, the devil and the deep blue sea, the damned if you do and damned if you don’t, it is the reason the ancient Greeks invented tragic theatre. Life often presents people with unfair choices. Life presents choices that no one should have to make, that no one can make, though doing nothing is also a choice. The thought-experiment starts by taking away one’s agency. You are in a life boat, and it is because your ship sank. You do not need expanded empathy; you need rescue. “Women and children” first” is the rule in any abandon ship scenario. In an extreme situation, this sounds like the captain and crew providing the empathic leadership required of them. That is the empathic moment, not “shoot the survivors.” The “take down” of Saad’s Suicidal Empathy requires an article of its own. One is available, though it is not a book review as such (though one is in preparation) see: “Suicidal empathy is in the news. . .” by Lou Agosta: https://louagosta.com/2026/05/22/suicidal-empathy-is-in-the-news-what-you-need-to-know-to-debunk-the-anti-empathy-skeptics/ ) Finally, for a detailed discussion and critique of the anti-empathy cohort prior to Saad see the prepublication version of Chapter 3: Empathy and its discontents from Lou Agosta, (2025), Radical Empathy in the Context of Literature(click here to download). Selected sections of the following are based on this chapter.
The very idea that our civilization at risk due to an excess of empathy is so laughably absurd and “out there” as to give pause that the advocate of the idea may perhaps be delusional. This is the same civilization (“the West”) that brought us two world wars, the Armenian Genocide, Auschwitz, Hiroshima (“seemed like a good idea at the time”), the war on terror (“seemed like a good idea at the time”), “forever” wars in the middle east, Chernobyl, the internment and annihilation of ethnic and racial groups too numerous to list here, and this civilization is suffering from an excess of empathy? Granted that the vast majority of people are empathic people devoted to family, career, community and country, Saad and his fellow travelers are sensationalizing empathy’s acknowledged limitations by throwing a rotten tomato at it. One can always make a splash by throwing a rotten tomato. If Saad had said, empathy doesn’t work with psychopaths, antisocial personality disorder, bullies, corrupt politicians, and the criminally insane, then it would be easy to agree with the position. With such individuals and groups, one must set firm boundaries, define forceful limits, call for backup, and speak truth to power.
Unfortunately, once a “policeman” is kneeling on your neck or someone throws a bomb, it is too late for empathy. The perpetrator fails the readiness assessment for empathy and it is necessary to invoke self-defense. And remember the best defense is a good offense—provided that it is proportionate to the incoming violence (which is notoriously hard to determine). Self-defense, setting limits, establishing boundaries are what is needed.
Furthermore, Empathy 101 teaches that empathy does not work on an active battlefield, or if one is starving to death, or hanging upside down in a torture chamber. Never underestimate the power of empathy—never—but empathy in such extreme situations ends up looking like what the FBI Hostage Negotiating team uses to open communication with the hostage takers, or looking like “Red Team, Red Team!”—think like the opponent in a war game (on Red Teaming see Zenko 2015). What then is the source of resistance to empathy?
Taking the debate up a level from any particular author’s book, let us consider the causes of resistance to empathy. First, the listener or would-be empathic person does not want to make him- or herself vulnerable to the upset, emotional disequilibrium, or trauma of the struggling individual who is narrating sharing his or her struggle.
Note that all the things said here about resistance to empathy can also be said about compassion, altruism, kindness, generosity, gratitude, and the related set of pro-social attitudes. If the empathic person risks “empathic distress,” the compassionate person risks “compassion fatigue.” All the helping professions and first responders are at risk of a kind of “burn out,” affective depletion, or using up of one’s emotional resources. That means that professional self-care is an essential part of the commitment to service and that those playing the Long Game of expanding empathy in the community have in place practices to renew their emotional resources.
Resistance to empathy on the part of the listener is resistance to being affectively flooded, overwhelmed or otherwise put at the effect of excessive stimulation of a negative or even positive kind, which in excess can be painful. For example, who would want to empathize with a person such as Geheimrat Daniel Paul Schreber at the height of his psychotic breakdown?[1] No one. However, in order to make a difference in helping Schreber it would be useful to get a taste of his distress, a sample of his fear, a vicarious experience of what he experienced as if in the theatre or film. So, if one is overwhelmed by emotional contagion, whether by empathic distress or compassion fatigue, then one is doing it wrong. One needs to take a sample of the other person’s distress, not the full-blown trauma itself. In empathizing, one needs to “tune up” one’s vicarious experience of the other and “tune down” one’s merger with them. This takes practice and even trial and error. Nevertheless, this is a real issue.
Given the level of empathy training, rare is the person who has enough control over their empathy regulation to tune it up or tune it down based on a continuum of disturbances varying from the mildly, everyday neurotic to the deeply psychotic. Note, however, that the antidote is expanded empathy. This bears repeating. If empathy is limited or parochial, then the solution is not to discard empathy to expand it, thus expanding inclusiveness and community.
Resistance to empathy also comes from the person who is the would-be recipient of empathy, compassion, etc. Pain and suffering can become a bad habit. The struggling individual is attached to their pain and suffering and these have become a kind of “comfort zone.” So letting go of the pain and suffering is itself more painful than the present pain. Letting go of the pain and suffering is filled with more pain and suffering than the person is willing to confront. As Marsha Linehan, the innovator in dialectical behavioral therapy (DBT), famously noted, the way out of hell is through misery. Overcoming the bad habits, blind spots, and maladaptive behaviors that are the causes of a person’s suffering requires struggle and effort that is itself a kind of misery. Who wants to hear that? No one. Better to stay in one’s comfort zone of discomfort. Furthermore, overcoming one’s limitations and getting the empathy, dignity, respect, and recognition for which one is so hungry risks an encounter with the Unknown – new possibilities which have not been previously available both for success and failure – and the unknown is the most anxiety inspiring thing possible. Hence, further resistance to empathy.
Finally resistance to empathy comes from institutional inertia, namely, the faceless unempathic bureaucracy that seems to live in every call center, customer service desk, government function, or need for trouble shooting with a new appliance, computer interface, or product return. Any business person knows that customer service requires empathy. This is one place where “empathy sells, and empathy’s limitations sell even better” is completely and patently false. Lack of empathy sends the customer to the competition (and the customer will not even tell you about it – you will just be out of business!).
If Gad Saad is complaining about the fake empathy at many customer service desks and call centers and sales pitches (in general), then we are in agreement. Unfortunately, he is not – he seems really to be anti-kindness and anti-empathy along the lines of “what doesn’t kill you makes you stronger” – even amidst a growing body count. In addition, one should not overlook that all-purpose tip and technique of “fake it till you make it.” Working from the outside inward – from practicing empathic behavior even if one’s feeling lag behind – is a proven method of “boot strapping” oneself into new skills and positive habits.
Regarding “what doesn’t kill you makes you stronger,” that notorious “bad boy” Friedrich Nietzsche called such qualities as altruism, compassion, charity, and pro social attitudes aspects of “slave morality,” tips and techniques that those out of power can use to get power. Note that Nietzsche never mentioned the word “empathy,” but engaged with related phenomena such as altruism, charity, and so on. What is so wrong with the disempowered trying to expand their power? Since the ruling class are not volunteering to give up power, how else would anyone get power than by strategizing and struggling? What is wrong with the poor, the disadvantaged, the marginalized, the survivors of domestic violence, refugees from conflict zones and natural disasters, the early Christians with whom the Romans literally fed the lions (this list is not complete) getting back some of their power? Was the USA – and the sitcom theme song “Movin’ on Up” – not premised on struggling African Americans, immigrants, and the marginalized getting a “piece of the pie”?
I cut to the chase. The criticism of empathy as “suicidal empathy” is a new form of Social Darwinism. What the heck is Social Darwinism? The short version of Social Darwinism is the wolves saying the sheep should have more understanding for the wolves. “We wolves are very hungry. Have empathy for us and come here and let us bite your neck.” It is the masters in the manor house saying the slaves in the dirt-floored cabins out back should be more sympathetic towards the masters. “The burdens of leadership are hard, and riding shot gun over a chain gang of enslaved workers in the hot Mississippi sun is not easy.” The admittedly simplistic account of Neo-Social-Darwinism in the context of survival of the fittest is: if you get “extinguished,” then you deserved it. Well, not exactly. It means in a high stakes game of random variations and natural selection, you drew the short straw. If you were born in poverty, in a conflict zone, in a land rendered uninhabitable by rising waters, forest fires, or climate change, you did nothing to deserve your pain and suffering. This is the classic dilemma of bad things happening to innocent people, which all world religions and most philosophical systems attempt to address in different ways. Empathy alone is not going to fix the problem of evil and suffering, but, I maintain, empathy is called forth by these and is an important part of the solution.
Further background on what we might formally label as Neo-Social-Darwinism: In the Gilded Age of the robber barons of capitalism, when Rockefeller’s Standard Oil company forced small competitors out of existence using monopolistic, anti-competitive, and corrupt business practices, Standard Oil justified the action by saying “survival of the fittest.” That is Neo-Social-Darwinism. For example, when in 1894 railroad workers went on strike in Chicago for better wages, health insurance, an eight-hour day, and working conditions (sounds familiar?), US President Grover Cleveland called out 15,000 US Army (federal troops) on July 3, 1894 to break the strike under the pretext that it was preventing delivery of the US mail.
Here is another example of abuse of power to further undemocratic ends: On April 20, 1914, the Colorado National Guard and guards of the Rockefeller-owned Colorado Fuel and Iron Company (CF&I), surrounded and attacked a tent colony of 1,200 striking miners, ultimately killing over 20 men, women, and children by randomly firing machine guns into the camp before burning it all down. The massacre caused a national outcry, violent sympathy strikes (the “Ten Days War”), and congressional hearings that disgraced the Rockefeller family’s public image. The miner’s families, however, were still dead. (See “The Ludlow Massacre”: https://en.wikipedia.org/wiki/Ludlow_Massacre.)
Not to minimize the abuses of power and rampant corruption in the current executive branch and Washington, DC, at large (Q3 2026), this is business as usual. Stephen Miller and Russell Voight, key policy architects and advisors to the current executive administration, seem to be studying the Grover Cleveland new gilded age play book and applying it to aspiring immigrants, diversity and inclusion, education, health care, and revisionist history that slaves were not so badly off. And if you believe that, I want to sell you the Brooklyn Bridge.
Full disclosure: I mistakenly subscribed to the view that no such thing as bad publicity existed, and I declined in 2018 (and up until 2023) to mention the anti-empathy authors by name, instead referring to an “evolutionary psychologist,” a “celebrity psycholinguist,” a prominent “Germanic studies” teacher, or a mandarin professor of comparative literature. Why give “free publicity” to views that were seemingly committed to inhibiting, contracting, devaluing, rather than expressing, expanding, and implementing the practice of empathy?
The gambit did not work. The devaluing of empathy got traction, perhaps driven by publishers whose market research, whether accurate or not, suggested that the sales of empathy books had peaked, and who proposed to keep the pot boiling with works that throw empathy “under the bus.” The challenge is that it is getting crowded under the bus. One can always make a splash by throwing a rotten tomato, and the would-be critique of empathy uncharitably takes the weakest version of empathy and refutes it. In contrast, a rigorous and critical empathy engages in a process of continuous improvement of empathy by “cleaning up” the empathic breakdowns of emotional contagion, projection, conformity, and communications lost in translation, resulting in the expansion of empathy in the individual and the community.
Yet another reason that the practice of empathy sells but empathy’s limitations sell even better is a consequence of empathy’s own success. Empathy works. Empathy makes a profound and lasting difference to those who are treated with empathy. But in the age of TikTok does empathy work fast enough? Empathy and its many successes are themselves the occasions for the skepticism, resistance, and embracing the obstacles to empathy. A rigorous and critical empathy can be hard work; being empathic can leave one vulnerable; better to take the easy way out. The reader may say, I want instant empathy, like instant coffee, just add hot water and stir. Wouldn’t it be nice? Nor is anyone saying such a thing as “instant empathy” is impossible. It may work well enough in a pinch; but like instant coffee, the quality may not be on a par with that required by a more demanding or discriminating appreciation and taste – or a more challenging situation.
The pervasive cynicism and resignation of the world are naturally attracted to attacking the sources of inspiration and strength, not those of enervation and stagnation. A treatise on “The Dark Sides of Violence” will sadly remain timely and relevant, but no one disputes the accuracy of the description. One does not need a treatise “Against Eating Dirt,” because few are inclined to eat dirt (and if one is so inclined, it seems be a sign of a vitamin deficiency).
This brings us to the poster child for devaluing empathy, Fritz Breithaupt’s The Dark Sides of Empathy (2017) (hereafter referred to as “Dark Empathy”). Breithaupt asserts on page 8 that to “uncritically embrace empathy without caveats” is the goal debunked by the end of this [Breithaupt’s] book. Those who “uncritically embrace empathy” are debunked. Just so. Please stop right there. Who proposed uncritically embracing empathy—or anything? Uncritically embracing empathy is not proposed here. Attributing uncritical thinking to the masters of empathy such as C. Daniel Batson (2009), Simon Baron-Cohen (2014), Frans de Waal (2009), Jean Decety and William Ickes (2009), Susan Lanzoni (2018), Micah Zenko (2015) (this list is not complete), is itself a concerning sign of lack of critical thinking. Dark Empathy is at best naïve and at worse disingenuous in imaging practitioners of empathy are uncritical or lack rigor. “Uncritically embracing empathy” sets up a strawman, and gives a green light to uncritical thinking.
The program of Dark Empathy is systematically and sensationally to attribute examples of empathic distress to the practice of empathy itself, charge empathy with these misfirings, and, going forward, invalidate and dismiss the practice of empathy. Instead of engaging with the hard work of self-inquiry into one’s own blind spots to overcome the obstacles and resistances to empathy, Dark Empathy takes the easy way out, discards empathy, gives up on it. It is like giving up on nutrition because the cook may put too much salt in the soup or burned the roast.
Dark Empathy properly lists many of empathy’s breakdowns, misfirings, and obstacles (as do practitioners of a rigorous and critical empathy). These include things such as emotional contagion, projection, conformity, messages getting lost in translations in attempting to be empathic. A rigorous and critical empathy is committed to doing the hard work of overcoming these break downs and misfirings in order to relate authentically and in integrity to the other individual. In contrast, Dark Empathy’s commitment seems to be to sensationalizing the failings of empathy, not demonstrating how empathy works (and does not work) in literature, politics, psychology, etc. Or rather the commitment is that empathy does not work (full stop).
If Dark Empathy would have stopped at page 8—empathy is what makes us human (or words to that effect) and elaborated on that position—then it would have made a useful contribution. The author really says it: empathy is essential to our humanity. However, empathy then breaks down into empathic distress. The issue is that human beings are frequently inhumane—not just a few bad apples, but as the Holocaust and Hannah Arendt taught us about the banality of evil, and the famous quote from the Nazi leader Heinrich Himmler, everyone has the potential for real badness, evil, even if few act on it. Therefore, dial back empathy, abstain from empathy? (See Hannah Arendt. (1971). Eichmann in Jerusalem. New York: Viking Press: 105–106; see also Lou Agosta. (2010). Empathy in the Context of Philosophy. London: Palgrave Macmillan: 73; this is the quotation from the Nazi Chief of the SS (Schutzstaffel) Heinrich Himmler and director of many of the genocidal programs against the Jewish people (and others) where he exhorts his men, seeming to demonstrate a kind of mutilated empathic understanding of how difficult it is to kill people and encouraging the executioners not to make any exceptions – and to kill them all. This is the paradigm case for a kind of “fiendish empathy” (as Heinz Kohut, MD, called it), and it might be redescribed as the breakdown of empathy in the presence of moral insanity and lack of integrity.)
Dark Empathy asserts sensible things about empathy up front, and then sensationalizes the negative and the resulting empathic distress by saying that empathic human beings perpetrate horrid actions. Accurate enough. Human beings are a difficult species. They are an empathic, caring, compassionate, and kind species as well as an aggressive, territorial, and rapacious one. Wouldn’t we want to work on expanding the former and inhibiting the latter?
That Roman soldiers drove nails through the limbs of the people they were crucifying does not invalidate the art of carpentry. Dark Empathy makes it sound like it does as it seemingly intentionally applies the same argument to empathy. Dark Empathy perpetrates a series of fallacies of numbing grossness by saying the forms of empathy are the motives for the horrid actions. This is not accurate. Aren’t the hidden variables aggression, uninhibited desire, territoriality (this list is not complete)?
The Dark Sides of Empathy succeeds in being provocative, even sensationalistic, identifying ways in which empathy can (and does) breakdown, misfire, and go astray. Yet The Dark Sides of Empathy is argumentatively uncharitable (in Donald Davidson’s sense): it uses the weakest versions of the empathy advocate’s arguments, not the strongest. On background, the analytic philosopher of language Donald Davidson innovated in defining a “a principle of charity”.
The principle of (argumentative) charity goes beyond honest translation or statement of an argument, as noted, asking the thinker to engage with the strongest version of an argument rather than intentionally weaking it through setting up a strawman or a distorted, ambiguous representation of the argument. (On “argumentative charity see: Donald Davidson. (1973). Radical interpretation. In Inquiries into Truth and Interpretation. Oxford: The Clarendon Press, 2001: 125–139 (the principle of argumentative charity is discussed on 136–137); I am adding the word “argumentative” to distinguish clearly Davidson’s logical meaning from “altruistic charity,” which a form of compassion; see also Jonathan Haber. (2020). Critical Thinking. Cambridge, MA: The MIT Press: 74.)
As noted, one can always make a splash by throwing a rotten tomato, and that is what The Dark Sides of Empathy does. The only concern is that my criticisms will sound like there is no such thing as bad publicity or sound like buying the book is worth it. It is not. I have read it very carefully, cover-to-cover, dear reader, so you do not have to. What a chore! Dark Empathy name drops Hölderlin, Goethe, Flaubert, Fontane, Hawthorne ((p. 172) one page only!), before turning to an in-depth engagement with the execution of the domestic (US) terrorist, Timothy McVeigh, the Oklahoma City bomber, which says as much about the dark side of the author as about any aspect of empathy. (Note: Timothy McVeigh (1968–2001): Executed by Federal authorities on June 11, 2001 for the bombing of the Alfred P Murrah Federal Building in April 1995 in which 168 people, including 19 children, were killed and 680 injured.)
One fundamental fallacy is to confuse empathic distress with empathy itself. That empathy can misfire and fail does not mean one should abstain from empathy. It means to expand one’s empathy one may usefully practice and develop one’s empathic capabilities. With practice and effort, one’s empathic abilities are broadened and deepened. The celebrated Self Psychologist and empathy innovator Heinz Kohut, MD, (who is not mentioned in Breithaupt) gives the example of the Nazis who equipped their dive bombers with sirens, the better to impart empathic distress in their victims, thus demonstrating their (the Nazis’) subtle “empathic” appreciation of their victims’ feelings. One is tempted to say, “The devil may quote scripture.” The devil frequently does, and Nazis and their fellow travelers may try to apply some subset of a description of “empathy.”
Note that Kohut speaks of “fiendish empathy” and the use of empathy for a “hostile purpose” while emphasizing his (Kohut’s) value neutral definition of empathy as “vicarious introspection” and a method of data gathering about the other person (1981: 529, 580).Nevertheless, the point is well taken that empathy is a powerful phenomenon in all its dimensions and requires careful handling.
The Nazi applies a kind of entry level emotional contagion or affective transmission of feelings, but the process breaks down at the point of empathic responsiveness. Empathic responsiveness requires a core of acknowledgement and recognition of the other person’s humanity.
Thus, it is arguably plainly evident that the would-be “empathy” of the Nazis or the white supremacists such as Timothy McVeigh[1] misfires and does so completely. The would-be empathy gets itself entangle in a practical contradiction. It is a contradiction to relate humanely to another person being while dehumanizing the person. Empathy doesn’t work that way. Empathic responsiveness simply does not admit of bombing people or disqualifying them as “less than” or other than human when they plainly are human.
The risk of Dark Empathy to the reader is that the reader may think its author is an expert in empathy and start quoting the distortions, lack of rigor, critical faux pas, and simple inaccuracies as if they shed light on empathy. For example, in a case of shocking inaccuracy, the book sites Stockholm Syndrome as an example of the dark side of empathy (p. 37). The mechanism of Stockholm Syndrome is not empathy, but “identification with the aggressor [key term].” Because the hostages identified with the aggressor (the bank robber and hostage taker) in order to survive a five-day traumatic kidnapping means that people do what they have to do to survive.
It is not an example of empathy, but of Dark Empathy’s lack of psychological acumen – and of empathy. As noted above, identification with the authority figure is crucial in forming the human moral conscience during childhood; and this same mechanism of identification “goes off the rails,” misfunctions or rather functions in a pathological or at least problematic way, in the case of a kidnapping, in which, in order to survive, the victim actually builds a relationship with the perpetrator – does not pretend to do so, actually builds the relationship.
Breithaupt’s interpretation depends on overlooking the basic definition of empathy that empathy requires a firm boundary between the self and the other. Remember the pessimistic philosopher Arthur Schopenhauer? His treatment of compassion and selflessness and/or merger, against which Nietzsche’s occasionally raged, are break downs of empathy. Never was it truer that “Good fences make good neighbors” (a fence, not a wall!), and there is a gate in the fence over which is the welcoming word “Empathy!”
A forced choice between more compassion and expanded empathy
In comparison with the long, hard slog through Dark Empathy, Paul Bloom’s Against Empathy is relatively easy to comprehend and situate. The case against empathy is that it is parochial, biased and limited based on preferences for “in group” individuals and associations such as family, neighborhood, and superficial similarities such as ethnic background, race, or local custom. Bloom’s recommendation is to pursue rational compassion. Bloom actually makes it sound like one has to choose between rational compassion and empathy. Given the state of the world, doesn’t the world need both more compassion and expanded empathy? The forced choice between the two must be declined.
Furthermore, the answer on the part of empathy advocates to the criticism of the “bias and limitation” of parochialism is direct: if empathy is sometimes parochial, the solution is not to abstain from empathy but to expand it. The empathic imperative is precisely: Be inclusive! Welcome the outsiders, the Others. Expanded empathy is what is required to broaden the scope and limits of the community to build harmonious and cooperative relationships that work for everyone. That building such a community is a high bar, takes nothing away from empathy. Given the complexity of the challenge, one would think that deploying various methods to make progress is proper.
As noted, Bloom’s choice between rational compassion and, as the title says, against empathy seems forced. Given the challenges at hand, don’t we need both empathy and compassion (of all kinds) to deal with this difficult species, human beings? Though I might be mistaken, I am not aware of any advocate of a rigorous and critical empathy who recommends abstaining from compassion. Why should advocates of rational compassion abstain from empathy?
Given that Against Empathy operates with the distinctions rationality and critical thinking (the latter implicitly), it has much to offer – just not much to offer against empathy. Its discussions of compassion fatigue, self-control, delayed gratification, caring and mirroring, the basis of morality, violence and cruelty, thinking about the consequences of one’s speech and actions, are all relevant to the dynamics between empathy and rational compassion.
Many of these distinctions such as self-control, delayed gratification, thinking about the consequences of one speech and actions, are features of adult behavior and speaking. Now it is a concerning fact that many adults are going about their business behaving in immature ways like adolescents who do not think about the consequences of their behavior and speaking. This says a lot about the breakdown of civility, education, and politics in our world, and, once again, the antidote is expanded rationality, compassion, and empathy.
This is a good place to note that empathy has a developmental sequence. The empathy of a two-year-old, who offers his own teddy bear to an upset grownup in tears whose adult suffering the child does not really understand, is on a continuum with, but different than, full adult empathy. Nor should the child’s empathy be dismissed. Children are exquisitely empathic, just not always with complicated adult issues. The adults deploy all the aspects of vicarious affect matching with the Other, appreciating who the other person is as a possibility, taking a walk cognitively in the Other person’s shoes (while remembering to take off one’s own to avoid project), and responding to the Other in a form of words and gestures that indicates to the Other that the listener “got” that with which the Other was struggling.
The key take-away on adult empathy with children in Christine Olden’s (1953) defining statement is as follows: when with a child, the adult is present to his or own fate as a child of the same age. Note that such a calling forth of the adult’s experience does not necessarily align his or her experience with that of the child in the moment, since the child may be happy and the adult unhappy (and so on), but the implicit experience called forth is the input to the empathic process of comparing and contrasting one’s own experience with that of the child out of which an empathic response can be produced.
What is characteristic of those against empathy is that they engage with the weakest version of the empathically-relevant phenomena at issue, not the strongest. They engage with the breakdowns and misfirings of empathy such as emotional contagion, projection, conformity, and communications getting lost in translation. All these are real enough occurrence, and the recommendation is to improve on empathy by analyzing what occurred and taking steps to improve the practice in context. Yet the tactic of the anti-empaths is to roll these misfirings up into the definition of empathy, and then invalidate empathy. In contrast with this argumentative lack of charity, the sound practice of empathy “gets it” that empathy can fail; and it is precisely in overcoming these failures, obstacles and resistances that a rigorous and critical empathy comes forth and gets implemented.
As noted above, the analytic philosopher of language Donald Davidson (1973: 136–137) innovated in defining a “a principle of [argumentative] charity.” One seeks for that in vain in Against Empathy, where the title itself seems to be a provocation. Nor is there anything wrong with that as such – just do not pretend that provocation and rhetoric (in the negative sense) are going to expand one’s empathy. Never was it truer, resistance to empathy makes obstacles to empathy a part of the defining features of empathy in order to dismiss it.
For example, if one is suffering from compassion fatigue or empathic distress, which is a professional risk of first responders and members of the helping professions such as doctors and therapists, then one recommendation is to “dial down” the compassion and/or empathy. If one uncharitably weakens empathy or compassion by representing them as an “on off” switch, then one is faced with the false choice between these pro-social practices and hard-heartedness. However, if one represents compassion and empathy as being something that one can dial up and down, granted this requires practice and training, then one has the possibility of sampling the other person’s suffering and pain vicariously. One has a vicarious experience – a sample or trace affect of the Other’s experience – and one is able to put one’s toe in the river of the Other’s suffering (so to speak) without being flooded by it. Much remains to be said about this, but, for our present purposes, the point is to decline the false choice between more compassion and expanded empathy. Both are needed.
A particularly problematic example that Bloom cites is the case in which empathy allegedly incites to violence. The example Bloom gives is the cases of lynchings of black men in the US South who were accused of raping white woman, in which lynchings, Bloom maintains, empathy for the white woman became a motive to the violence. How shall I put it delicately? Simply stated, lynchings were a way of maintaining white supremacy and domination of black people through violence and should never be represented in any other way. Racism is the systematic denial of empathy.
These false accusations against innocent black men, who were literally grabbed off the street, are fanatical delusions similar to those that Jewish people drank the blood of Christian babies or that extra-terrestrials from Mars invaded New Jersey in 1931 – lies, damn lies, and total nonsense. I am sitting here holding my head in my hands and rocking back-and-forth quasi-catatonically. I am sick at heart. To site this racist accusation of rape as an example of empathy or motivating an empathic reaction is the reduction to absurdity of Bloom’s entire project. He just doesn’t get it. Even argumentative charity has its limits. At the very least, Bloom is tin-eared and unempathic to cite this common racist stereotype of rhetorical violence preceding physical violence, which is a tactic of domination, Jim Crow, white supremacy, and the imposition of injustice by violence. The most charitable thing to do to undo something so off the rails is to apologize and resign.
On background for the reader’s historical empathy, in 1931 eight black young adults and one juvenile, henceforth known as “The Scottsboro Boys,” were falsely accused of raping two women. After examination by a medical doctor, no evidence of rape was found. They were tried by an all-white male jury for rape and sentenced to death for the rape(s) (except for the juvenile, who was sentenced to life in prison). The NAACP and the Communist Party (regarding the latter, even a broken clock tells the correct time twice a day) provided legal assistance to the young men and stopped the State from executing them; but they had to endure long and unjust years in prison. With this historical vignette of struggle for justice and empathy ringing in our ears, we turn to the next example of empathy under stress.
Mutilated empathy
Migrant Aesthetics by Glenda Carpio sets up an either/or choice between ending empire (e.g., racism, colonialism, imperialism, and so on) and expanding a rigorous and critical empathy. The book then mutilates empathy by confusing it with projection, emotional contagion, conformity, and other forms of miscommunication. The result is some 285 pages of penetrating analysis in which the reader does not get a single example of the practice of empathy resulting in a successful empathic relatedness in literary fiction (which is the author’s area of expertise and discussion). The attempt by Migrant Aesthetics to force a choice between expanding empathy and ending (or limiting) empire must be refused. Both results – ending (limiting) empire and expanding empathy – are needed. More on that shortly. (See Glenda Carpio. (2023). Migrant Aesthetics: Contemporary Fiction, Global Migration, and the Limits of Empathy by Glenda Carpio (New York: Columbia University Press.)
The good news is that empathy works whether one names it or not, whether one believes in it or not. Contra Carpio’s constant carping (forgive me, I just couldn’t resist), the practice of a rigorous and critical empathy knows that it can be wrong and can break down, misfire or go astray, flat out fail, as projection, emotional contagion, conformity, or communications getting lost in translation. It is precisely in engaging with and overcoming these obstacles and resistances to empathy that empathic relatedness and community are brought forth. Like with most powerful methods, skills, or interventions, practice makes the master. As a successful and popular teacher, Carpio knows the value of empathy, nor is mention of the word itself required.
The issue is that in 285 pages of penetrating, incisive analysis of migrant aesthetics (the category, not the title), Carpio does not provide a single example of what an effective empathy would look like. The reader is not given a single example of a healthy empathic relatedness that works, so that one could identify it if one happened to encounter it. This bears repeating: in some 285 pages of summary and analysis of the literary fictions of Dinaw Mengestu, Teju Cole, Aleksandar Hemon, Valeria Luiselli, Julie Otsuka, Junot Diaz, and some nonfiction of others, Migrant Aesthetics does not cite a single example of empathy that works right or functions as designed.
Not one. Granted that empathy does not always succeed, the reader of Migrant Aesthetics does not learn what a healthy, rigorous and critical empathy might look like if, rare as it may be (as empathy skeptics assert), if one happened to encounter empathy. None. Not one single example of what empathy looks like when it succeeds in producing empathic relatedness. This must give the reader pause. We take a step back—but not too far back.
Caprio asserts: “…[W]hat has been my central argument in this work: that the history of empire is key in understanding the roots of migration at a scale appropriate to its global dimensions (Carpio: p. 228).” That to be forced from one’s home and become a refugee of the road is definitely a source of pain, suffering, and trauma. Here the connection is direct—cause (routed from one’s home by aggression, starvation, etc.) and effect (pain, suffering, trauma). At the risk of over-simplification, yet a compelling one, white Europeans with cannons and machine guns go to Africa and Asia and exploit the natural resources and enslave or dominate the locals. A small subset of the locals is coopted—analogous to the concentration camp capos, both perpetrators and survivors (until they are not) being chosen from the prisoners—to make the job of domination by the ruling class easier. Even the surviving prisoners then become perpetrators as one starving prisoner “steals” bread or water from another or lies to save his own skin, thereby endangering another. And some of those local migrants journey back to headquarters, whether Boston, London, or New York, and some become the celebrated authors of migrant fiction (the literary distinction not the title).
Empathy is a powerful tool in deescalating conflict and restoring dignity to aggrieved parties and survivors of empire, and has been successfully employed in doing so from the troubles in Ireland to the Truth and Reconciliation session in South Africa (see Donna Hicks on Dignity (2011)). However, if anyone seriously believes that empathy is going to solve the problems created by empire, colonialism, imperialism, and so, then—how shall I put it delicately?—empathy is being “over sold.” This is usually the first step in setting up empathy as a “strawman” to be blamed for not fixing the many challenges facing civilized human beings committed to building a community that works for all persons.
There are at least two hidden variables behind the problematic causal analysis of empire that would help connect the dots between empire and empathy-based solutions: Human aggression and human hunger (hunger for many things, but here for food). These human beings are an aggressive species—and biologically omnivores. People can be kind and compassionate and empathic, but they also can behave aggressively and violently. Even if committed vegetarians, people also need to eat quite regularly, if not exactly three times a day.
To say, as Migrant Aesthetics does, that the arrival of the white European conquistador and their horses in the new world in 1492 was a catastrophe for the original inhabitants gets the measure of the event about right. In a way, the displacement of the Cherokee Nation from Georgia to Oklahoma is a kind of migration; but not really. It is a death march with strong aspects of genocide.
By all means denounce empire, but a more useful approach consistent with such righteous indignation might be to elaborate an analysis of human aggression, territoriality, lack of education, lack of critical thinking, the disturbing tendency of many human beings (“true believers” (Hoffer 1951) fanatically to follow authoritarian figures off a cliff. In that context, empathy is a proven way of deescalating violence and aggression and restoring dignity to the survivors.
There is a readiness assessment for empathy, and it requires that one be relatively safe and secure in one’s own person. Above all, the readiness requires a willingness to inquire into one’s own blind spots and preconscious biases. Empathy “the hard way” does not take the easy way out – e.g., bell hooks’ “eating the other” – the hard way includes the work of taking the Other’s perspective, giving up being righteous, giving up being aggrieved, asking for what one needs, and so on.
As it stands, Migrant Aesthetics misunderstands empathy, mutilates it, and then blames empathy because empathy can be misapplied by migrant authors, some of the male members who are both perpetrators and survivors, for calling attention to their plight and that of the devalued Other within us all.
The other hidden variable is that these humans are a hungry species. At the risk of over-simplification, long since incurred, the development of Cyrus McCormick’s combine-wheat-reaper, and the follow-on agribusiness technology, allow some 2% of the population to grow enough food to feed the entire planet; and this in spite of the fact that human choices made under aggression continue to use food as a weapon of starvation. Prior to the Green Revolution, the other 98% of the population had to work twelve to sixteen hours a day to grow enough food to avoid slow death by starvation. As noted, the migrant classics, admittedly shot through with empire, of Willa Cather and Ole Edvart Rolvaag, confront hunger as an ever-present specter, pending a successful harvest. Meanwhile, apparently large dairy herds really do contribute to greenhouse gases.
The grievance against empathy continues: Migrant Aesthetics writes (p. 4): “More broadly, the genre of immigrant literature depends on a model of reading founded on empathy—a model that my book takes to task. Literature promotes empathy, we are told, but empathy can easily slip into a projection of readers’ feelings and even into outright condescension.” As a reader, I am holding my head in my hands and rocking back-and-forth quasi-catatonically. Projection is a breakdown of empathy. I am in disbelief at the lack of common sense, lack of critical thinking, and absence of argumentative charity in confusing empathy and projection. Projection is a misfiring and/or going off the rails of empathy. Projection is a “getting lost in translation” of empathy. Now attribute these to empathy and dismiss empathy. Hmmm.
As regards “a model of reading founded on empathy,” please stop right there. Reading the story would not work—would not make any sense—would, strictly speaking, be unintelligible without empathy. Reading and empathy are joined at the hip, so to say. Without empathy, the actions and contingencies, the struggles and high spirits, setbacks and successes, that are represented in the story would be strange sounds and gestures appearing to an anthropologist on Mars or on her first day in an alien culture, prior to marshalling her empathic skills. Never underestimate the power of storytelling, but absent empathy, it does not get traction. Reading is founded on empathy. Reading teaches one to walk in someone else’s shoes. Reading takes one to worlds that don’t exist, like the world of Harry Potter. One can feel what it was like for Rosa Parks to refuse to sit in the back of that segregated bus in 1955. This calls out the convergence of reading and empathy—both open up new worlds, both provide vicarious experiences of the lives of Others, both point to possibilities that had not previously been imagined. In both reading and empathy, we relate to an Other—in the one case in-person, in the other case, in-fiction or the vicarious presentation of historical narrative.
If the reader did not bring the capacity for empathy to the reading of the text, the text itself would not make sense. Reading the simplest narrative about a snowman melting in the spring thaw, much less Tolstoy’s Anna Karenina’s anguish at being patriarchally denied access to her son, would be unintelligible. Without the vicarious experience of empathic receptivity, the reading of the most dramatic fiction will be indistinguishable from reading the railroad schedule when the rail workers were on strike. Meaningless. Unintelligible. The water streaming from the abandoned child’s face would not be tears; the clenched fist would not be anger but an excess of adrenaline; the trembling would not be fear but Parkinson’s disorder. The migrant bones in the desert over which no one prayed would be calcified carbon, not an anguished cry for help and human response.
Without empathy, one would perhaps be able to provide an accurate description, whether as fact or fiction is irrelevant here, of the Other’s behavior from a third person perspective, but the behavior would lack vitality, energy, strength, aliveness, and relatedness to the things that matter to human beings. One would truly be like the philosopher Descartes looking out the window at people on the street below, wondering if the entities that appear to be people are really instead robot-like automata. Descartes was practicing an exercise in radical doubt, whereas the reader that lacked the capacity for empathy would be practicing an exercise in radical draining of meaning from the text in every sense from pragmatics to semantics—encountering empty words describing empty behavior, as noted, like reading a train schedule during the railway strike, instead of reading an engaging narrative such as Anna’s emotional, moral, cognitive. spiritual struggles to attain self-knowledge and personal fulfillment.
However, Migrant Aesthetic responds: You have now got the point. Drive out empathy to let justice and a small set of related responses come forth. It doesn’t work. Migrant Aesthetics “forecloses” (rejects) empathy, then immediately lets empathy back in. Empathy is indispensable, and it cannot be kept out.
Carpio (p. 8): “[…] [T]he writers I examine reject empathy as the main mode of rationality, opting instead for what Hannah Arendt called “representative thinking” that is, they urge reader to think, as themselves, from the position of another person and thus to call into question their own preconceptions and actions” [italics added]. Thus, Migrant Aesthetics rejects empathy while calling out “the position of another person,” which is precisely the folk definition of empathy.
Arendt’s reference here is of course to a single line in Immanuel Kant’s Third Critique (1791/93: AA 158) about “enlarged thinking” [erweiterten…Denkungart] that is, to think from the perspective of the Other. Sounds like the folk definition of empathy to me. This cipher of “enlarged thinking”, which remains unintegrated in Kant, became the inspiration for Arendt’s incomplete third volume of the life of the mind on political judgment. Once again, it is the folk definition of empathy.
The point is that Migrant aesthetics (the book, not the distinction) politicizes aesthetics with anti-fascist, anti-imperialist, anti-empire-ist commitments, rhetoric (in the classical sense), and expressions, without necessarily making practical recommendations for political action. Migrant Aesthetics expels empathy from the garden of artistic achievement, because empathy does not provide a stable basis for political action.
Never underestimate the relevance of Immanuel Kant, yet if one wants measurable results from political action, apply Saul Alinsky’s Rules for Radicals (1971) or analysis based on Eric Hoffer’s The True Believer (1951), not Kant’s Third Critique. Hoffer calls out the mutilated logic of totalitarian thinking; and Alinsky knew quite a lot about building community, and though he did not use the word “empathy,” empathy lives in building community. (See also Tristam Adams. (2016). The Psychopath Factory: How Capitalism Organises Empathy, London: Repeater Books, so the capitalist takes a walk in the Other’s shoes in order to sell him another pair; is nice to the workers in order to improve productivity; it seems to work well enough – see also the Chapter in Lou Agosta, The Lazy Person’s Guide to Empathy (with illustrations by Alex Zonis) on “Empathy: Capitalist tool.”)
In short, the rumor of empathy remains a rumor in the cases of Gad Saad’s Suicidal Empathy, Breithaupt’s Dark Empathy, Bloom’s Against Empathy or Carpio’s Migrant Aesthetics; the rumor is not confirmed; and empathy does not live in this work. It is where empathy goes to become projection, emotional contagion, and fake empathy. It is where empathy goes to become mutilated empathy like mutilated fragments of human bones in the desert. Don’t go there.
In summary, it is not a choice between expanding empathy and ending/reducing empire, and an engagement with both is needed. Survivors ask for empathy. When survivors are asked, “What do you want—what would make it better? What would soothe the trauma?” then rarely do they say punish the perpetrator (though occasionally they do). Mostly they ask for acknowledgement, to be heard and believed, to hear the truth about what happened, for apology, accountability, restitution, rehabilitation, prevention of further wrong (see Judith L. Herman, MD. (2023). Truth and Repair: How Trauma Survivors Envision Justice. New York: Basic Books). Rarely do survivors make forgiveness a goal if that would require further interaction with the perpetrator (though self-forgiveness should not be dismissed). It bears repeating: though both are needed, survivors do not ask for an end to empire, but for empathy.
References
Tristam Adams. (2016). The Psychopath Factory: How Capitalism Organises Empathy, London: Repeater Books
Lou Agosta. (2010). Empathy in the Context of Philosophy. London: PalgraveMacmillan.
Lou Agosta. (2018/2024). Empathy Lessons, 2nd Edition. Chicago: Two Pears Press.
Lou Agosta. (2025). Chapter 3: Empathy and its discontents, in Radical Empathy in the Context of Literature. Palgrave Macmillan Press. Click here to download.
Lou Agosta. (2025). Radical Empathy in the Context of Literature. Palgrave Macmillan Press. Click here for Lou Agosta’s Amazon page.
Saul Alinsky. (1971). Rules for Radicals. New York: Vintage, 1989
Hannah Arendt. (1971). Eichmann in Jerusalem. New York: Viking Press: see especially pp. 105–106.
C. Daniel Batson. (2009), These things called empathy Eight related but Distinct Phenomena. In The Social Neuroscience of Empathy, eds. Jean Decety and William Ickes. Cambridge, MA: The MIT Press, 2009: 3–16.
Paul Bloom. (2016). Against Empathy. New York: Ecco (Harper Collins).
Fritz Breithaupt. (2017). The Dark Sides of Empathy, Andrew Hamilton (tr.). Ithaca, NYY: Cornell UP.
Glenda Carpio. (2023). Migrant Aesthetics: Contemporary Fiction, Global Migration, and the Limits of Empathy. New York: Columbia UP.
Simon Baron-Cohen. (2014). Zero degrees of empathy. RSA [Renaissance Society of America] Video Presentation: https://youtu.be/Aq_nCTGSfWE [checked on 2023-02-26];
Donald Davidson. (1973). Radical interpretation. In Inquiries into Truth and Interpretation. Oxford: The Clarendon Press, 2001: 125–139
Jean Decety and William Ickes. (2009). The Social Neuroscience of Empathy. Cambridge, MA: The MIT Press.
Jonathan Haber. (2020). Critical Thinking. Cambridge, MA: The MIT Press: 74.
Judith L. Herman, MD. (2023). Truth and Repair: How Trauma Survivors Envision Justice. New York: Basic Books
Donna Hicks. (2011). Dignity. New Haven: Yale UP.
Eric Hoffer. (1951). The True Believer. New York: Random.
Immanuel Kant. (1791/93). Critique of the Power of Judgment, trans. Paul Guyer and Eric Matthews. Cambridge: Cambridge UP, 2013: AA 158.
Heinz Kohut. (1981). “On Empathy,” The Search for the Self: Volume 4: Selected Writings of Heinz Kohut 1978-1981, London: Karnac Books, 2011: 525–535; see 529, 580 on empathy as vicarious introspection.
Susan Lanzoni. (2018). Empathy: A History. New Haven: Yale University Press; Micah Zenko. (2015). Red Team: How to Succeed by Thinking Like the Enemy. New York: Basic Books.
The Ludlow Massacre: https://en.wikipedia.org/wiki/Ludlow_Massacre
Christine Olden. (1953). On adult empathy with children. Psychoanalytic Study of the Child, Vol 8 [annual]: 111–126.
Namwali Serpall. (2019). The banality of empathy. The New York Review: https://www.nybooks.com/online/2019/03/02/the-banality-of-empathy/?lp_txn_id=1496946 [checked on 10/20/2023].
Tunku Varadarajan. (July 10, 2026): Gad Saad on Suicidal Empathy and Western Decline: https://www.wsj.com/opinion/gad-saad-on-suicidal-empathy-and-western-decline-cdae269f?st=6zthGs&reflink=desktopwebshare_permalink
Frans de Waal, Oct 3, 2009, Our kinder, gentler ancestors: https://www.wsj.com/articles/SB10001424052748704471504574449012560741086?st=jhYLwQ&reflink=desktopwebshare_permalink
Frans de Waal. (2009). The Age of Empathy: Nature’s Lessons for a Kinder Society. New York: Harmony Books (Random House).
Tara Wells. (2017). Compassion is better than empathy, Psychology Today: https://www.psychologytoday.com/us/blog/the-clarity/201703/compassion-is-better-empathy?msockid=38a4e0db840c639d1086f7d48545627f
Micah Zenko. (2015). Red Team: How to Succeed by Thinking Like the Enemy. New York: Basic Books.
Note: No generative AI or AI of any kind was used in the preparation and execution of this blog post or its publication or recorded version.
© Lou Agosta, PhD and the Chicago Empathy Project
[1] Daniel Paul Schreber (1842 – 1911) is the most famous schizophrenic of the late 19th and early 20th Century. He was the equivalent of a federal judge before his illness and in a successful attempt to convince the authorities of his recovery and to release him he wrote Memoirs of a Nervous Illness New York, trans. Ida Macalpine and Richard A. Hunter: New York Review of Books Publications, 2000. Sigmund Freud, Carl Gustave Jug, and Karl Jaspers all engaged with Schreber’s work in their own respective ways. Also relevant are Louis Sass (1994). The Paradoxes of Delusion: Wittgenstein, Schreber, and the Schizophrenic Mind. Ithaca, NY: Cornell University Press and Eric Santner. (1996). My Own Private Germany: Daniel Paul Schreber’s Secret History of Modernity. Princeton, NJ: Princeton University Press.
[1] 1968–2001: Executed by Federal authorities on June 11, 2001 for the bombing of the Alfred P Murrah Federal Building in April 1995 in which 168 people, including 19 children, were killed and 680 injured.
(c) Lou Agosta, PhD and the Chicago Empathy Project
Empathy and Greek Tragedy – Connecting the Dots
I can hear the laughter at the back of the auditorium – and indeed in the first row – a new definition of tragedy? You have got to be kidding!? Okay, maybe George Steiner (1963) or Christoph Menke (2009) already covered it – so send me the reference – in which case I modify my assertion to “an aspect of tragedy that may usefully be highlighted, foregrounded, and made the subject of further inquiry.”
If one thinks about the characters in tragic dramas such as Oedipus, Creon, Agamemnon, Antigone, Jocasta, Orestes, and Electra, they do not seem to be particularly cowardly or slavish. The representation in theatre of the latter qualities of cowardice, etc. caused Plato to ban (“censor”) theatre from his ideal city-state in The Republic; but maybe something was lost in translation and cowardice is really hamartia (the fatal flaw(s) of the tragic hero).
What does represent a common thread is that the protagonists (“heroes”) are survivors who become perpetrators (or vice versa) and they are brought low not only by the usual theatrical information asymmetries, boundary violations, and fatal acts of revenge, but by moral trauma. Moral trauma is someone who seems to have no other choice than to commit an integrity or boundary violation.
What has been overlooked is the role of moral trauma. Moral trauma is defined as the distressing emotional, behavioral, social, and sometimes spiritual aftermath of exposure to (including participation in) events in which a person’s moral boundaries are violated and in which individuals or groups are gravely injured, killed, or credible threat thereof is enacted (i.e., individuals are physically traumatized) (Litz et al 2009; Shay 2014).) The agent, is put in a double-bind, in which, whatever the action, innocent people are going to suffer and die.
The double bind is created in diverse was. The double bind is created by information asymmetries (Oedipus does not know his biological parents, etc.); by conflicting laws of the family versus political authority in which Antigone is caught; by a curse in the form of sexual desire on the part of Phaedra for her step son, which, when revealed, even as a fantasy, represents a proposed boundary violation so immoral that the suggestion as thought itself requires punishment; by the commitment to a life of crime in support of Jason on the part of Medea that, once unleashed, is unstoppable (“might be hung for stealing a sheep as well as a lamb”); whether the best way to right a wrong inflicted on someone (Philoctetes), whose good will has now turned out to be indispensable, is to tell the aggrieved party the truth and risk rejection or try to trick the party into cooperating thereby performing a further perpetration; not knowing the future, an escaped slave about to be returned to slavey kills her baby to prevent her from being raised in slavey and is thwarted from then killing herself (Morrison’s Beloved). More pedestrianly, one decided on a last-minute change of plans and did not get on the airplane—or trolley car—that crashed–or, due to a last-minute change of plans, one did. The irreparability and irreversibility of catastrophe is a feature of a world infused with contingency. In literature this has a name. It is called “tragedy.” In such a world, radical empathy is an indispensable constituent in the project of finding one’s way forward through the fog of suffering to reconciliation and transfiguration of empathic distress into community and the possibility of fulfillment and satisfaction.
On further background for those who may need a review of the narrative, Oedipus is a survivor who is abandoned as a baby to die by his biological father but is rescued by a kindly shepherd, who foster him. Survivor. Learning of the Oracle that he will kill his father, Oedipus leaves home and unwittingly meets the biological father on his path of exile. An altercation occurs and Oedipus unwittingly kills the biological father, thus fulfilling the Oracle; but more significantly, the survivor now becomes a perpetrator. In the case of Antigone, the “double bind” is that she must either violate the laws of the family that require one bury one’s next-of-kin or violate the laws of the city that require one be a team player and defend the home-team against it’s enemies (who also happen to be next of kin). In moral trauma one is caught between a rock and a hard place – the devil and the deep blue sea.
Clytemnestra and her boyfriend, Aegisthus. may be more problematic cases—and they initially show up like villains in their adultery and homicide and treachery. Yet Clytemnestra is a survivor. Agamemnon killed Clytemnestra’s first husband Tantalus and then married her, the distinction “consent” apparently not being readily available at the time. Tough crowd. Agamemnon had adulterous adventures while he was away at war, but his wife, Clytemnestra, firmly oppressed in the patriarchy, should not? This leads naturally, by way of free association, to the equally tough case of Medea. Medea is a kind of monster, though, I assert contra Plato, not a particularly cowardly one. One wonders what tragic spectacles Plato was attending. Even if these spectacles were the same ones with which the tradition makes one familiar, the argument can be made that denial is not the only and perhaps not even the optimal method of educational. Even if one swallows all the anachronistic refinements of a society built on slavery prohibiting the representation of slavery as subversive (of course it is, but for different reasons), there have still got to be better educational methods than denial.
The confrontation with errancy (hamartia) on the part of individuals with whom one can imagine identifying—perhaps in one’s wildest dreams—and taking their place, leads to being grabbed by the throat and having one ‘s heart ripped out in pity and fear. The “fatal flaw” is usually not thought of as being both a survivor and a perpetrator, but it turns out to mean that too. That is the educational moment—that is the training—that is the therapy, if one may say so. It is rather like a spa treatment where one takes the healing waters and then drinks a double dose of a powerful purgative. One has to hold one’s nose as one’s bowels are loosened. Catharsis is different than preparation for a colonoscopy, but perhaps not by much. It is not a rational process—it is an educational and therapeutic one. The monstrous has an unexpected healing power (The Birth of Tragedy quoted in Schmidt (2001: 218))—if one survives the literary encounter with it in the literary artwork without succumbing to empathic distress.
This points immediately to Nietzsche’s answer to Plato’s banning of tragic poetry from the just city (the Republic), namely, that humans cannot bear so much truth (1883: §39):
Indeed, it might be a basic characteristic of existence, that those who would know it completely would perish, in which case the strength of a person’s spirit would then be measured by how much ‘truth’ he could barely still endure, or to put it more clearly, to what degree one would require it to be thinned down, shrouded, sweetened, blunted, falsified.
And again, with admirable conciseness, Nietzsche (1888/1901: Aphorism 822): “We have art, lest we perish of the truth.” Here “truth” is not a semantic definition such as Davidson’s (1973, 1974) use of Tarksi (loosely a correspondence between language and world), but the truth that life is filled with struggle and effort—not fair—that not only are people who arrive early and work hard all day in the vineyard paid a full day’s wages, but so are people who arrive late and barely work also get paid a full day’s wages; that, according to the Buddha, pain is an illusion, but when one is sitting in the dentist chair, the pain is a very compelling illusion; not only old people get sick and die, but so do children. While the universe may indeed by a well-ordered cosmos, according to the available empirical evidence, the planet Earth seems to be in a local whorl in its galaxy where chaos predominates; power corrupts and might makes right; good guys do not always finish last, but they rarely finish first, based alone on goodness.
So much for Nietzsche’s response. The answer of the tragic poets (e.g., Aeschylus, Agamemnon 173–181) provided even before the question is posed by Plato, is “learning through suffering” (pathei mathos). Note well this is consistent with Plato’s guidance not to celebrate examples (whether in Epic or in Tragedy) of cowardly, slavish, or devaluing actions (which Socrates famously denounces (Republic: 395a–396b)). But we humans seem to learn the hard way—in the college of hard knocks. The suffering takes on a life of its own. Literary fiction is the phantom-limb-pain of life.
The learner is a survivor, who is in pain, but no corresponding reality of the missing limb exists, which limb, in being amputated, has become fictional. If the suffering is fictional, so perhaps is the therapy—write a poem, a tragedy, or tell a story. Life mutilates the individual, and, even if one gets through life relatively unscathed, one dies and the “celebrants” throw dirt in one’s face. Creon says “Alas. I have learned, unhappy as I am” (Antigone 1271–1272); but at that point Antigone is dead and Creon’s life is a ruin. The lesson is not for Creon, but for the audience (or reader).
Yet this is not informational learning. The tragic protagonists (e.g., Antigone) cannot learn from her error, since she is crushed by it—yet the audience can. A hard lesson indeed. The double bind—disrespect the state or disrespect one’s ancestors—is to be caught between the proverbial rock and the hard place. That so many antidotes and answers to the pain and suffering are proposed, is itself evidence that the latter can readily slip loose from one’s mastery and control, which are predictably tentative and temporary, and ruin one’s day, if not life. For the audience knows the outcome, or at least sees it coming ahead of the protagonist. Yet the audience cannot use the knowledge to produce a different factual result—hence the need for alternative fictional methods. It is not like some specific error occurs that could be corrected through better intelligence or information—check the brakes on the Trolley so that they do not fail inopportunely—it is rather that no matter how much one knows, how carefully one assesses the risks of one’s action, the outcome is still uncertain and may even be disastrous.
What kind of knowledge is that? The one certain piece of knowledge—death awaits. Yet it could be that from the audience’s perspective—the lesson is to dance in the chaos—dance in the uncertainty (so to speak)—between now and the ultimate un-over-comeable end of possibility. One double-checks the brakes, knowing full well there no guarantee exists, but that the checking is an expansion of control over uncertainty. With 20-20 hindsight, contingency starts to look like fate—that which, by definition, cannot be avoided; and yet daily counter-examples abound. A man named “John Silber” (1926–2012) is born with a birth defect—a mis-formed right arm that ended in an appendage like a thumb. Fate or rather contingency? Silber goes on to become a celebrated educator, University President, Kant scholar (which is how I got to know him), profiled on the front page of The Wall Street Journal (in the days of print journalism), and candidate for governor of Massachusetts. This was not a predictable result. Fate starts to look less constraining. The power to begin something new— “natality” as Hannah Arendt called it—new possibilities show a way forward.
The double bind is the source of tragedy, but is not alone sufficient to generate tragedy. For if one remains with the double bind, one gets “ruin and wreck,” not tragedy. For if one stays with the double bind, one gets “empathic distress.” One gets a form of insanity, not tragedy. One becomes a Philoctetes abandoned in pain and suffering, alone on an island for ten years before the return of Odysseus, Neoptolemus, and Hercules. The double bind presents a conflict but then requires that one not question the contingent framework of the conflict. Thus, the double bind is often kept in place, spinning in a tight unproductive circle, by a lack of imagination. Antigone does not think to act to claim sanctuary in the Temple of Hestia, virgin goddess of the family (which, of course, would be a different drama). The lesson? Write a poem—tell a story—use one’s imagination to brainstorm alternative possibilities—decline the constraining “set up” —embrace radical hope: “To hope till Hope creates from its own wreck the thing it contemplates” (Shelley 1820: 153; see also Lear 2008).
In moral trauma one is no longer an agent in the full sense, which is one of the key hidden variable in classic tragedy—loss of agency. One’s agency is compromised by information asymmetries. Oedipus does not know who are his biological parents and he does not know that he does not know! One’s agency is compromised by inconsistent standards of behavior between the family and the political community, in which “cross fire” Antigone (and her family) are brought low. Now act! One is required to choose in the face of moral trauma—a choice one cannot make, that one ought not to have to make, but that, in any case, one is required to make.
Our empathy for the agent starts out requiring a decision that no one should have to make. In classic tragedy, the individual is forced to make a decision that neither the agent nor anyone else is authorized to make. But that agent has to make it anyway. Doing nothing is also a decision, and people are going to die. This is the definition of a double bind—damned if one does, and damned if one doesn’t.
Empathy is always empathy and radical empathy applies the same four aspects of relatedness—receptivity, understanding, interpretation, and responsiveness. Radical empathy emerges from standard empathy, when standard empathy breaks down, misfires, and/or fails in the face of empathic distress (including “burn out” or “compassion fatigue”). Empathic distress is itself a function of physical trauma, moral trauma, double binds, soul murder, and tragic circumstances that act to destroy possibilities of human flourishing, strength, aliveness, energy, and/or vitality. As a matter of definition, “soul murder” is defined by Henrik Ibsen’s John Gabriel Borkman (1896), as destroying (through emotional or physical abuse) the possibility of love, but is generalized here to include destroying the possibility of generating new possibilities (Shengold 1989).
Radical empathy is attained when standard empathy honors the commitment to empathize in the face of empathic distress – the reaction on the part of audiences to circumstances in which tragic protagonists become entangled.This is empathy the “hard way,” and it is rare. However, no other way exists of attaining radical empathy than through empathy pure-and-simple—“standard empathy”—and much of the work accomplished here engages with the break downs of standard empathy as emotional contagion, projection, pressure to conform, and communications getting “lost in translation.” The repairs of these misfirings—and, it must be acknowledged, failures—of standard empathy lead the way to radical empathy. The transfiguration of moral trauma, double binds, and so on, by classic tragedies, work to overcome empathic distress, and, is on the critical path to performing and attaining radical empathy.
Without standard empathy, the audience does not experience the pain and suffering of the struggling humanity in the story of the runaway trolley. Even if the experiences are vicarious ones, there is no pity and fear without empathy in witnessing the unavoidable conflict that tears apart the protagonists. However, if the viewer (reader) is able to sustain one’s commitment to empathy in the face of the breakdown of standard empathy into empathic distress, then the possibility of radical empathy opens up. Radical empathy has much to contribute here.
A short description is that radical empathy relates empathically to that which causes empathic distress. Radical empathy relates to those decisions that no human being has the right to make, can make, or should have to make, but then ends up making anyway. Radical empathy reveals that one can be both a perpetrator and a survivor. Hence, the definition: the theatrical representation of moral trauma, double binds, and compromised agency, occasioning empathic distress, that calls forth the overcoming or amelioration of empathic distress by means of radical empathy for the survivor/perpetrator. Empathizing with such individuals and circumstances is why tragedy was invented.
References
Donald Davidson. (1973). Radical interpretation. In Inquiries into Truth and Interpretation. Oxford: The Clarendon Press, 2001: 125–139.
___________________. (1974). On the very idea of a conceptual scheme. In Inquiries into Truth and Interpretation. Oxford: The Clarendon Press, 2001: 183–198.
Henrik Ibsen. (1896). John Gabriel Borkman, tr W. Archer. New York: Project Gutenburg e-Book, 2006.
Jonathan Lear. (2008). Radical Hope. Cambridge, MA: 2008.
B. T. Litz, Stein N, Delaney E, Lebowitz L, Nash WP, Silva C, Maguen S. Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clin Psychol Rev. 2009 Dec;29(8):695-706. doi: 10.1016/j.cpr.2009.07.003. Epub 2009 Jul 29. PMID: 19683376.
Christoph Menke,, (2009). Tragic Play., tr James Phillips. New York: Columbia University Press.
Friedrich Nietzsche. (1883). Thus Spoke Zarathustra, R. J. Hollingdale (tr.). Baltimore: Penguin Press, 1961.
________________. (1888/1901). The Will to Power, R. J. Hollingdale (tr.). New York: Vintage, 1968.
Dennis Schmidt. (2001). On Germans and Other Greeks. Bloomington: Indian UP.
J. Shay, (2014). Moral injury. Psychoanalytic Psychology, 31(2), 182-191. https://doi.org/10.1037/a0036090
Leonard Shengold. (1989). Soul Murder Revisited: Thoughts About Therapy, Hate, Love, and Memory. Hartford: Yale UP.
Percy Bysshe Shelley. (1820). Prometheus Unbound in Selected Poetry: Percy Bysshe Shelley, Harold Bloom (ed.). New York: Houghton-Mifflin (Signet Classic Poetry), 1968: 120–212.
George Stein. (1963). The Death of Tragedy. New York: Alfred Knopf.

IMAGE Credit: Wikimedia: Painting from an ancient Corinthian vase. Ajax falls on his sword in the presence of his colleagues, Odysseus and Diomedes. The short stature of Odysseus is a well-known Homeric feature. These vases are black-figured; the heroes are painted in silhouette on the red ground of the vases. Their names are appended in archaic Greek letters. Artist from ancient Corinth; public domain; between circa 800 and circa 480 B.C.; drawing published 1911.
(c) Lou Agosta, PhD and the Chicago Empathy Project
Radical empathy is now a podcast!
Listen to the podcasts on Spotify:
Radical empathy is empathy defined as the practice of empathy that remains committed to empathizing in the face of empathic distress. Once again, it must be emphasized—and empathized—that one does not necessarily know one’s limits in dealing with trauma until they are tested in experience. Here are the three key distinctions between standard and radical empathy. 1. Radical empathy processes empathic distress whereas standard empathy is stopped by it. 2. Empathic distress is reliably occasioned and caused by physical trauma, moral trauma, soul murder, double binds, Trolley-car-like dilemmas (to be defined further)), and diverse tragic circumstances that are hard, if not impossible, to capture in standard uses of words and language. 3. Radical empathy is required when one or both of the would-be empathic partners is both a survivor and a perpetrator (which itself points to empathic distress). Given these three invariables, both standard and radical empathy share empathic receptivity, empathic understanding, empathic interpretation, and empathic responsiveness. I repeat: standard and radical empathy share receptivity, understanding, interpretation, and responsiveness. The differentiator is what happens with empathic distress. When one or more of these aspects of standard empathy breaks down or misfires, the repair or overcoming of the breakdown reliably presents the possibility of transforming standard into radical empathy. Radical empathy is not for the faint of heart, and instead of an image of puppies, the above painting, by Caravaggio, is a portrait of Medusa, whose hair was transformed into snakes, turning to stone (paralyzing) all those who met her and looked at her in person. If you are confronting trauma, be sure to bring your radical empathy.
Read / Listen to (subscribe to) this blog and A Rumor of Empathy on Spotify for further updates on radical empathy.
Short summary of episode one: This episode on Radical Empathy – what it is and why it is important – is the first in a series inquiring into radical empathy, what it is or whether it is just a rumor; how radical empathy differs from standard empathy; how radical empathy and everyday, standard empathy overlap and the dynamics of their interactions; how radical empathy makes a difference in situations when standard empathy breaks down and fails; and how the listener can expand his or her empathic skills, getting power over empathy and apply empathy in one’s lie, relationships, career, family, in the individual and in community.
The occasion for this podcast series on radical empathy is the publication of my new book Radical Empathy in the Context of Literature (April 2025 from Palgrave Macmillan). The suggestion is to have your local community or university or institute library order a copy. They have budget for these things and one can save a couple of dollars. This work on Radical Empathy contains many examples of empathy, both standard and radical, that are eye opening and engaging in their lessons for empathy and life.
Order books on empathy by Lou Agosta on empathy by searching for “Lou Agosta” and “empathy lessons” on your favorite online book source or click on this shortened URL: https://shorturl.at/gsGal
Image art credits: QWERTY, oil paint on board by Alex Zonis (AlexZonisart.com); The Shadow of Empathy (Doll Heads) by Alex Zonis (AlexZonisart.com; Head of Medusa by Caravaggio (Gallery of the Uffizi (Florence, Italy)) from Wikimedia Commons.
