The gentle and sensitive companionship of an empathic stance… provides illumination and healing. In such situations, deep understanding is, I believe, the most precious gift one can give to another."
― Carl R. Rogers
Empathy clearly has immense value in therapy. Feeling understood, and feeling that one is in the presence of another who is attempting to really know what it’s like to be us, can offer great relief and healing. One of my favourite poets, Walt Whitman, said “I do not ask the wounded person how he feels. I myself become the wounded person.”
But empathy, like other emotional responses like anger, can be used for a variety of means, positive and negative. Recent books by the likes of social psychologist Paul Bloom have challenged the common assumption – held widely in therapeutic circles, in my experience – that we can never have too much empathy. So perhaps it’s a good time to look at the use of empathy in psychotherapy.
But first, what actually is empathy? I think we usually take empathy to mean the act of experiencing the world as another does. This separates empathy from compassion, which we can define as a strong feeling of sympathy or sadness for another’s experience. I don’t think this is just a semantic difference. We use different parts of our brain when we empathise than when we are being compassionate towards another. They are different responses, with different uses in therapy.
Empathy is not a universally positive emotional response. Intimate understanding of another’s experience can be used to manipulate and hurt them. As Bloom notes in his book Against Empathy, an empathic response can lead to in-group bias, where we value more those who look, sound and act more like us.
So, there is no reason to believe empathy is always of positive use in life, therapy included. I think there are times when a more objective response based on love, kindness and compassion is of greater value for our clients. Consider a session with a client who is telling us about their unbearable pain and grief at the loss of a loved one. Is it likely to be therapeutic to experience that same grief at the same time as the client? I doubt that it would be. Instead, it’s possible that it would be more helpful in that moment to imagine, with a caring and compassionate attitude, what it is like for them in that moment, and consider from that vantage point what could be a helpful response (even if that response is a respectful silence). Put in different language, using the prefrontal cortex to mentalise with the client might be more helpful than using the anterior cingulate cortex to empathise with them.
We risk being flooded with pain, fear and uncertainty if we remain too often in a truly empathic state, unable to provide a potentially healing presence. Sometimes we need to be at our most calm when our clients are at their most anxious, to be able to relay that we understand their plight, and that they are heard. When we feel compassion, our heart rate slows down, we secrete oxytocin, and regions of the brain linked to caregiving light up, which can encourage an approach response in us. By modelling compassion, we perhaps offer an example that can open the door for our clients to have greater compassion for themselves.
There is another potential danger from focusing too relentlessly on empathy: therapist burn-out. It requires enormous energy and can be extremely draining to try and have literally the same experience as another, particularly another in distress and pain. Knowing when best to draw on empathy and when to shift into a more compassionate, mentalising state can preserve our energy for our clients and for our lives outside our work. Easier said than done, of course, and I certainly can’t claim to know how best to strike that balance! But it’s worth keeping in mind, particularly when we’re feeling like the work is getting on top of us.
Empathy is invaluable in therapy. It can be truly healing to feel felt by another. We need to be able to truly understand and care about our clients’ experiences. But I don’t think we always need to be feeling what they feel. Unlike Paul Bloom, I’m not Against Empathy. But I’m definitely Pro Compassion.