Empathy
Neither animals nor humans are selfish, writes a known primatologist De Waal (2009). Empathy is an ancient trait, as old as maternal care; mothering based on being sensitive to and anticipating the needs of developing offspring is more successful than less responsive types of care.
De Waal thus turns upside down the long-held notion of humans (and other animals) as competitive and supremely selfish, concerned only with their own survival and perhaps the survival of their offspring. Instead the author finds huge amounts of empathy, cooperation, and concern amongst species, tribes and other groups, and families.
It all starts with “emotional contagion,” which is a primitive form of true empathy. In essence, we are simply infected with others’ emotions or behavior. De Wald holds that cognitive empathy is a higher state that allows us to understand and actually feel the emotions of the others.
This capacity arose long ago with motor mimicry and emotional contagion, after which, evolution brought small modifications, until our ancestors not only felt what others felt but also understood what others might want or need. This enhanced their ability to survive and propagate.
When empathy was discovered?
Prior to the development of the notion of empathy, Theodor LippsFootnote 1 introduced the term Einfühlung or Einfühlungsvermögen (German: “feeling with” or “managing feeling with”), which referred to the tendency of perceivers to project themselves into the objects of perception and experience them as being “in” the object, so that they were “felt” as well as “seen” (Håkansson 2003). The term empathy per se was coined by Edward Bradford Titchener,Footnote 2 in the process of developing Lipp’s concept of Einfühlungsvermögen (Håkansson 2003).
Empathy seen as an affective reaction
It seems that most definitions highlight the affective reaction as the backbone of empathy. This approach is well represented by Roy (2010), who posits that empathy is an essential part of emotions and is itself a specific emotion involving a feeling element of familiarity or connection and a bodily reaction of verbal or nonverbal communication. Empathy in general would mean feeling what the other person is feeling and “being in the shoes of the other.”
Eisenberg and Strayer (1990): “In our view, empathy involves sharing the perceived emotion of another—“feeling with” another” (p 5) or Roy (2010): “Empathy is an essential part of emotions and is itself a specific emotion involving a feeling element of familiarity or connection and a bodily reaction of verbal or nonverbal communication. Empathy in general would mean feeling what the other person is feeling and “being in the shoes of the other.” [—] Empathy is closely related to intuition and, like intuition, helps in the understanding and recognition of emotions in others. Empathy is thus described as recognizing other people’s emotions through intuition and is marked by a feeling of connecting to the other person.”
Stotland (1969), Hoffman (1987), and Barnett et al. (1987) also delineated empathy in affective terms and conceptualized empathy as feeling a vicarious emotion that is congruent with, but not necessarily identical to, the emotion of another.
Cognitive and epistemological aspects of empathy
In the 1930s both MeadFootnote 3 (1967) and PiagetFootnote 4 (2008) emphasized the cognitive aspects of empathy, highlighting the ability to understand the other, beyond mere “feeling into.” Mead, especially, saw children’s ability to role play as the key to their development. He put forward that meaning “arises in experience through the individual stimulating himself to take the attitude of the other in his reaction toward the object” (Mead ibid, p. 545). Piaget emphasized empathy as a cognitive function requiring an individual to de-focus on her or himself and imagine the role of another (Håkansson 2003).
Bandura (1969, 1971) introduced the mechanism of vicarious learning, i.e., an ability to emotionally learn by observation; he noticed that the two components of vicarious learning are firstly, the behavior of a model that produces reinforcement for a particular behavior, and secondly, positive emotional reactions aroused in the observer.
De Vignemont and Singer (2006) also highlight the epistemological role of empathy, because by sharing the emotional state of others, we are well-equipped to develop a more precise and direct estimate of others’ plausible future actions. Also empathy provides knowledge about important environmental properties, as we emotionally learn by observation, e.g., seeing someone being burned by a machine, we attach a negative “avoidance” value to the machine, without having experienced pain ourselves. In this sense empathy is an efficient computation tool for acquiring knowledge about the attributes of the world around us.
Empathy as connectedness
Empathy relates to connectedness and to a sense of just knowing what another person is feeling, and is closely related to intuition (Roy 2010). Moreover, it can be defined as recognizing other people’s emotions through intuition and a feeling of connecting to the other person (Roy idem). Pavlovich and Krahnke (2012) document that empathy enhances connectedness through the unconscious sharing of neuro-pathways that dissolve the barriers between self and other.
Gallese (2005, 2009) analyzes connectedness as embodied simulation. In his recent paper (Gallese 2014) he highlights the role of the bodily interaction indicating that the discovery of mirror neurons led to the proposal of an embodied approach to intersubjectivity; in that perspective intersubjectivity is being viewed as intercorporeality.
Empathy as a mixed affective and cognitive reaction
Eisenberg (2002) considered both emotional and cognitive factors and defined empathy as “an affective response that stems from the apprehension or comprehension of another’s emotional state or condition, and that is similar to what the other person is feeling or would be expected to feel” (p 135). Similarly, Davis (1996), Pavlovich and Krahnke (2012), and Ickes (1997) depict the emotional and cognitive aspects of empathy.
Moral aspects of empathy
Empathy plays a key role in contribution to altruism and compassion for others in physical, psychological, or economic distress. It provides feelings of guilt over harming someone and feelings of anger at others who do harm. Empathy is a pivotal factor in the parental behaviors that foster moral internalization in children. It is also a gateway to internalizing abstract moral principles (Hoffman 2001), especially in that it includes “ethical responsibility in the face of the Other” (Thompson 2001, p. 17).
Social aspects of empathy
Empathy is also a departure point for pro-social behavior and cooperation. People help others more when they report having empathized with them. On the contrary, individuals with empathy deficits are more likely to display aggressive, antisocial behavior toward others. Some say that lack of empathy during development results in lack of morality. However, empathy is not a necessary condition for taking pro-social action; it additionally requires sympathy to be a motivation for reaching out and helping (De Vignemont and Singer 2006).
Kinesthetic empathy interaction (KEI)
Sometimes strange things happen to one’s imagination, especially when one watches a dance performance. Spectators of dance, even while seated, often feel they are participating in the movements they observe and experience related feelings and ideas. This is called kinesthetic empathy interaction (KEI), delineated as movement empathy, a foundational technique of dance/movement therapy, in which practitioner and client move in synchrony. The other name used for this phenomenon is attunement. Spectators can internally simulate movement sensations of speed, effort, and changing body configuration (Hagendoorn 2004; Fogtmann 2007).
However, some call this this bodily reaction “motor mimicry” and depict it as “primitive empathy,” see: Eisenberg and Strayer (1990).
The complex phenomenon of empathy
Empathy seems a complex phenomenon, having many dimensions: interactive, cognitive, affective, epistemological, moral, social, and collaborative—see Fig. 1:
This leads us to a syndromic concept of empathy, seen as the ability, constructed by emotional, cognitive, behavioral and communicational competencies, to tune into the internal states of the others.
Defining empathy
Some authors propose that there are three primary aspects of empathy: an affective response to another person, a cognitive capacity to take the perspective of the other person, and some self-regulatory and monitoring mechanisms that modulate inner states evoked by the empathetic reaction (Thompson 2001). However, the variety of definitions of empathy have been vague or confusing; as a result, operational definitions of and measurement techniques for empathy vary greatly from one study to another (Gerdes et al. 2010, 2011; Segal et al. 2012).
Empathy so defined could manifest itself regardless of the reaction of the other, including in those situations where the other doesn’t even observe our reaction. In other words: A person may express empathy more intensively with some people than with others, e.g., some may empathize especially strongly with children of alcohol abusers or with social innovators struggling against all odds. The level of a person’s empathetic reaction may also vary according to the situation, e.g., some may be more prone to empathize in the context of natural disasters, others in the context of a performing art. Empathy might lead to action (“empathetic action”, Gerdes et al. 2011) but not necessarily (Hoffman 2001); it is, however, usually associated with intention to respond compassionately to another person’s distress (Thompson 2001).
Empathy differs from compassion as compassion demonstrates caring for others, but it tends to be limited to feeling sorry for. It also differs from sympathy defined as “feeling an emotion triggered by seeing/learning of someone else’s distress which moves you to want to alleviate their suffering.” (Baron-Cohen and Wheelwright 2004, p. 165). Empathy goes further, being an ability to see the world through others’ eyes, sensing and understanding their feelings in the same way as they do (Segal 2007).
Measuring empathy
The conceptualization of empathy, especially the embraced dimensions (cognitive, emotional, behavioral, etc.), determines the measurement techniques, which differ in various studies, making it difficult to identify one, comprehensive approach (Gerdes et al. 2010).
Currently, one of the two most popular assessments, the Empathy Quotient (EQ), designed to be short and easy to use, encompasses both affective and cognitive components (Baron-Cohen and Wheelwright 2004). Satisfactorily valid and reliable it is especially applicable to the field of mental health, i.e., to the Autism Spectrum Disorder (Lawrence et al. 2004).
The other approach developed in the social work field is called Empathy Assessment Index (EAI). It’s based on five dimensions: affective response, self–other awareness, perspective taking, emotion regulation, and empathic attitudes (Lietz et al. 2011; Gerdes et al. 2011) and as such, seems comprehensive, grasping all the critical components of empathy.
What’s missing, however, is the kinesthetic interaction, a critical component for measuring SYNC (see later in this article).
Can we learn empathy?
We can definitely ingrain and enhance this capacity in small children. De Wall also (ibid) believes that empathy can be enhanced, as we do when we urge a child who is hogging all the toys to be more considerate of her playmates.
Roots of Empathy
Some are doing that work now. For example, Mary Gordon (2005) is known for her program Roots of Empathy, which significantly reduces aggression among schoolchildren while raising social/emotional competence and increasing empathy. In the program a parent and infant engage with students in the classroom. A Roots of Empathy Instructor guides the children as they observe the relationship between baby and parent, helping them understand the baby’s intentions and emotions. Through this model of experiential learning, the baby serves as “teacher” and catalyst, helping children identify and reflect on their own feelings and the feelings of others. An longitudinal research on the impact of the Roots of Empathy program (Berkowitz and Bier 2007) documented that Roots of Empathy children demonstrated lasting:
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increase in social and emotional knowledge
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decrease in aggression
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increase in pro-social behavior (e.g., sharing, helping, and including)
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increase in perceptions among ROE students of the classroom as a caring environment
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increased understanding of infants and parenting.
Immerse virtual reality embodiment reducing racial bias
Although the act of merely observing in immerse virtual reality (IVR) the pain of other racial group representatives doesn’t stimulate sensorimotor empathic brain responses (measured using transcranial magnetic stimulation; Avenanti et al. 2010), it was noted that embodiment in IVR might reduce racial prejudice. Experiments with the embodiment of light-skinned participants in a dark-skinned virtual body (VB) significantly reduced participants’ implicit racial bias against dark-skinned people (Peck et al. 2013; Groom et al. 2009). Notably, however, other techniques, such as imagining the dark-skinned person’s perspective in real life, had no significant impact on racial bias (Groom et al. ibid).
This means that IVR-embodiment into another’s VB may reduce racial (or political, interpersonal, and other) biases and merits further exploration in areas such as conflict resolution and peacemaking.
Empathy helps
The Roots of Empathy program indicates that developing empathy as a means to prevent antisocial behaviors such as bullying and juvenile aggression also helps prevent later problems including dropouts, juvenile delinquency, and addiction.
On a societal level, the ability to share other people’s emotional experiences and to react to them might facilitate social communication and create social coherence (De Vignemont and Singer idem).
Empathy prevents
Indeed, empathy is identified as an essential ingredient for effective parenting, especially for the mother of a distressed infant, and as protection against the possibility of aggression (Dolan and Fullam 2007). Engaging empathic processes in children and adolescents results in reducing their aggression; this sort of empathy training may be useful for encouraging positive social behaviors (Björkqvist 2007). It also builds social intelligence and negatively correlates with direct types of aggression: physical and verbal (Kaukiainen et al. 1999). Moreover, there are better prospects for improved long-term prognosis of psychopathy if treatment is aimed at increasing the empathic reaction of children with psychopathic tendencies (James and Blair 2007).
Healing by empathy
There are also indications that empathy may be a curative factor in various disorders (Farrow et al. 2005); the authors proved that building empathy is useful for healing PTSD. Scanning the brain (fMRI) they found that PTSD patients, after a cycle of modified cognitive behavioral therapy aimed at understanding others and being more empathetic, demonstrate a significant increase in the neural response to social cognition tasks. These findings can be a gateway to an empathy-based therapy program for PTSD patients.
And who hasn’t experienced the beneficial influence of benevolent medical care? Researchers also document the vital importance of the doctor-patient relationship and the role of empathy. Doctors should listen to their patients, communicate with them, and thus the physician and patient become partners in the healing process. This enables the process of healing by empathy (Adams 2010). Moreover, empathy is an important element of healthcare professional and patient communication and is a key feature of emotional intelligence. Health professionals should be trained to effectively implement empathy, in order to achieve the desired therapeutic results (Ioannidou and Konstantikaki 2008).
A very special healing relationship based on empathy is the psychotherapeutic bond. Since the advent of Carl Rogers’ client-centered approach based on empathetic understanding (Rogers 2003), the results of much research indicate that empathy, in its contemporary understanding, is not only an essential part of the therapeutic alliance (Bergemann 2011), but also (or first and foremost) a curative factor per se (Staemmler 2011). Truly empathic therapists are also skilled inquirers, sensitively attuned to their clients and appropriately involved in the therapeutic process (Erskine et al. 1999). The quality of the therapeutic relationship is seen as the best predictor of success in psychotherapy and is the backbone of empathetic facilitation of the client’s own problem-solving capacities (Bohart and Greenberg 1997).
Immersing oneself in the experience of the other through an empathetic relationship enables sensitive interpretations that help clients access unconscious experience. Moreover, it becomes a gateway to co-constructing new understanding (Bohart ibid).
A closer look at the psychotherapeutic relationship from the synchrony perspective is presented in this paper.