Empathy—What Is It?

Source: REDPIXEL

Affect, cognition, and language are intimately connected with the concept of empathy. Empathy implies being aware of, being sensitive to, and vicariously experiencing another’s feelings, thoughts, motives, and experiences. Empathy does not include judgment of those feelings, and it is not sympathy or compassion.

Empathy has a large literature—it has been discussed in detail by Kohut (1959, 1966, 1971), Basch (1983, 1988), and many others. They ask: “How does empathy occur?” This is a deceptively complicated question. Kohut suggested that empathy is “accomplished by introspectively gaining direct access to our ideation, to our feeling states, to our tensions, our affects, and to those of others via vicarious introspection…by the use of a variety of cues that we obtain, and on the basis of the essential similarity between people, we can with some hope of correctness and accuracy grasp what another person feels, experiences, thinks” (Tolpin & Tolpin, 1996, p. 350).

Kohut also brought up the assets and complexities which language brings to the issue: “Communication by language is, of course, one way in which this particular type of vicarious introspection is furthered. Somebody tells us what he feels; then we know what he feels. Or we take it with a grain of salt, since he may not be telling us the truth. That kind of thing. The methodology of the introspective, empathic observation of the psychological universe is another story. It needs as many, if not more, safeguards than those we use in appraising verbalized statements” (Tolpin & Tolpin, 1996, p. 350).

Basch conveys the importance of including affect, cognition, and language as all contributing to what we call empathy. He highlights the importance of Tomkins’ accurate identification of affects and the significance of putting language to the affects (1976; Katan, 1961).

However, he does not stop there. He also proposes that empathy is a part of a developmental process involving affect. Basch suggested the term affect be used for the subcortical visceral and vascular reactions. He uses the term feeling when affective reactions begin to be related to a concept of self, around 18-24 months. Emotion refers to the joining together of feeling states with experience, to give meaning to our more complex concepts, such as love, sadness, and happiness. Basch proposed the “final maturational step in affective development is the capacity for empathic understanding—that is, affective communication that goes beyond the self-referential” (1988, p. 78, emphasis in original).

Empathy, the ability to put oneself in the place of another, represents, I believe, the final potential transformation of affective communication. On the level of cognitive operations empathy depends on “decentering,” a term used by Piaget (Piaget and Inhelder, 1969) to describe the ability to take an objective view towards one’s own self through both reflection and what Vygotsky called “inner speech” (Basch, 1983, p. 118-119).

Empathy and the Clinical Arena

The concept of empathy received increasing attention in psychoanalysis during the second half of the twentieth century with the work of Heinz Kohut and the development of self-psychology. Beginning with his 1959 paper (“Introspection, Empathy, and Psychoanalysis---An Examination of the Relationship Between Mode of Observation and Theory”), Kohut used the concept of empathy to focus on the self (an experience-near term), narcissistic problems, and disorders of the self. From this he described a different way of exploring, understanding, and treating these patients. He ultimately suggested alternative ways of viewing their development and the transferences which resulted (1966, 1971, 1977, 1984; Tolpin & Tolpin, 1996).

Basch elaborated on the nature of empathy in the therapeutic setting: “…it often requires from us a long period of listening to what the patient is saying (or not saying), examining our own reactions to this material analytically, and then bridging the gap between ourselves and the patient by constructing suitable analogies between his associations and our own experiences, before we finally may find ourselves attuned to the patient’s affective communications" (1983, p. 112).

Ralph Greenson (1960) described his understanding of the empathic process in analysis as one of immersion overtime: “I listened to the patient’s words and transformed her words into pictures and feelings from her memories and her experiences and in accordance with her ways…. The events, words, and actions the patient described were now permitted to permeate the working model. The model reacted with feelings, ideas, memories, associations, etc.” (p. 421, emphasis in original).

Empathy in Other Situations

Up to now, empathy has been discussed primarily in terms of one person trying to understand the feelings and motives of another—e.g., therapist and patient. But empathy can also be seen as an interaction, a process, between two or more people or groups trying to understand each other.

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What about a person who wants to be empathized with, who wants someone else to understand him/her? In a sense, this is what evolution has done for infants. Negative affects are SOS signals for the caregivers—distress, fear, anger. It is as if the babies are saying: "I need help—I am in trouble—can't you see how I feel?"

There is another situation seen in children and adults, when individuals or groups try to force others to empathize with them. This may occur when one person hurts another physically: "See how it feels? This is how it feels!" Motives underlying rage and a desire for vengeance can combine with a need to be understood (“I want to hurt you, and I want you to hurt and feel my pain…. This is how it feels to be hurt!"). These actions may be triggered by being wounded somehow and a need to have the other person feel and understand those feelings, to empathize and do something about the situation. This dynamic is also seen in groups---group protests, riots, insurrections, strikes, revolts, and so on.

Empathy: Additional Questions

Many issues surrounding empathy still appear unsettled. Is empathy innate? How is it intertwined with development? Can it be learned or enhanced through therapy? Perhaps all of these issues may be involved at one time or another

Is empathy innate? I know of families with several children, one of whom seemed from the beginning to be more naturally empathic than the others.

Is empathy part of development? Recall Alison Gopnik’s cognitive studies of infants. She found that 18-month-olds had the capacity to understand that the experimenter liked the broccoli even when the babies did not…but that the 14-month-olds could not make that distinction. In contrast, Basch suggested that decentering (i.e., self-and-object differentiation), which is what Gopnik observed in an 18-month-old, was a necessary developmental step toward empathy that occurs much later—around Piaget’s concrete operational stage, at about 7-11 years old.

Can empathy be developed or enhanced through therapy? There is much to suggest this occurs frequently (e.g., Basch, 1988). Much of therapy involves identifying with and learning from therapists’ efforts to understand the internal world of other people. Various therapeutic theories (e.g., mentalization, mindfulness) have focused on the process of helping patients to develop the capacity for empathy, resulting in success in various modes of functioning (Fonagy et al., 2002; Hoffman et al., 2016).

To summarize:

Empathy is crucial for human relationships and clinical work. The affect of interest (curiosity) is the fuel for empathy. Enhancing curiosity in early development and beyond will heighten empathy and self-understanding.