Abstract
Critical thought and assessment of medical, emotional, and social problems faced by patients is central to genetic counselor training and development. However, primary emphasis on these critical problem-solving approaches can interfere with the development of empathic listening skills. Using a narrative medicine approach, I describe how learning to reframe one patient’s story of healing as a gift allowed me to become a more open and empathic listener. Ultimately, the empathy and understanding that I learned from this patient’s narrative added to what previous patients had taught me and helped me assist other patients (and myself) in identifying and nurturing healing narratives for people coping with illness and grief. The approach presented here emphasizes the importance of recognizing patients as valuable teachers in the development of higher-level empathy skills.
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Notes
By “empathy” I mean to experience an emotional reaction that was in tune with a clients’ experiences and appropriately communicate that understanding (Veach 2006).
“Overidentification,” used here, refers to the experience of feeling too much with your client (Veach 2006, pp. 52,59). Taking on too much emotional information too quickly can create distress and actually distance counselors from their clients. Ideally, developing empathy happens gradually so that appropriate levels of empathy can be achieved without risking overidentifaction.
The genetic counselor may, for example, need to assess a client’s psychosocial condition and needs, their understanding and emotional response, the medical facts of the case, the inheritance patterns and genetic risk, and the case management plans (American Board of Genetic Counseling, Inc.).
There is often a tendency among Western health care providers to emphasize the intellect over the emotion (Veach 2006, p. 61). This was a tendency that I struggled with.
The emphasis on these critical thinking skills over empathy skills is also reflected in the language of the ABGC Practice-Based Competencies which uses some version of the term “assess” ten times, but only mentions empathy twice and caring for patients once, and never uses terms like “compassion” or “sympathy.” This is not a criticism of the document, which clearly states that these are “entry-level” skills; I infer from this comment, however, that with ongoing experience the genetic counselor should be expected to develop and hone their emotional skills.
Though, to be honest, there was not always enough time to be able to follow through and listen to these stories even when it could have been beneficial.
References
American Board of Genetic Counseling, Inc. (n.d.). Practice-Based Competencies. Retrieved April 28, 2015, from www.ABGC.net: http://www.abgc.net/docs/Practice%20Based%20Competencies_Aug%202006%2010-29-09.pdf.
Charon, R. (2001). Narrative medicine: a model for empathy, reflection, profession, and trust. Jama, 1897–1902.
National Society of Genetic Counselors (2006). NSGC Code of Ethics. Retrieved April 28, 2015, from www.nsgc.org: http://nsgc.org/p/cm/ld/fid=12.
Veach, P.L. (2006). Facilitating the genetic counseling process: A practice manual. Springer Science & Business Media.
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Anne C. Spencer declares that she has no conflict of interest
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Spencer, A.C. Stories as Gift: Patient Narratives and the Development of Empathy. J Genet Counsel 25, 687–690 (2016). https://doi.org/10.1007/s10897-015-9886-9
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DOI: https://doi.org/10.1007/s10897-015-9886-9