Empathy is a provider attribute that has been a topic of increased clinical interest, particularly as it relates to pain. This article examines various dimensions of the pain and empathy literature: definitions of empathy, research regarding the psychophysiology of empathy for pain, and research related to empathy in psychological and medical care. Research regarding topics broadly related to empathy is also reviewed, including communication skills and patient-centered care. Although this literature supports the clinical value of provider empathy and/or behaviors likely to reflect empathy, little research has explicitly examined empathy in the treatment of pain. Nonetheless, when considered in the broader context, the evidence is sufficient to draw some conclusions regarding approaches to pain care that are likely to reflect and/or elicit provider empathy and are central to effective pain management.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
References and Recommended Reading
Rogers C: The necessary and sufficient conditions of therapeutic personality change. J Consult Psychol 1957, 21:95–103.
Levinson W, Gorawara-Bhat R, Lamb J: A study of patient clues and physician responses in primary care and surgical settings. JAMA 2000, 284:1021–1027.
Wasan A, Wootton J, Jamison R: Dealing with difficult patients in your pain practice. Reg Anesth Pain Med 2005, 30:184–192.
Schneider J, Kaplan SH, Greenfield S, et al.: Better physician-patient relationships are associated with higher reported adherence to antiretroviral therapy in patients with HIV infection. J Gen Intern Med 2004, 19:1096–1103.
Preston SD, de Waal FBM: Empathy: its ultimate and proximate bases. Behav Brain Sci 2002, 25:1–72.
Jackson PL, Rainville P, Decety J: To what extent do we share the pain of others? Insight from the neural bases of pain empathy. Pain 2006, 125:5–9.
Singer T, Seymour B, O’Doherty J, et al.: Empathy for pain involves the affective but not sensory components of pain. Science 2004, 303:1157–1162.
Mead GH: Mind, Self, and Society: From the Standpoint of a Social Behaviorist. Chicago: University of Chicago Press; 1934:27.
Eisenberg N: Empathy and Related Emotional Responses, vol 44. San Francisco, CA: Jossey-Bass; 1989:108.
Sherman JJ, Cramer A: Measurement of changes in empathy during dental school. J Dent Educ 2005, 69:338–345.
Coulehan JL, Platt FW, Egener B, et al.: “Let me see if I have this right...”: words that help build empathy. Ann Intern Med 2001, 135:221–227.
Davis MH: Measuring individual differences in empathy: evidence for a multidimensional approach. J Pers Soc Psychol 1983, 44:113–126.
Hojat M: Empathy in Patient Care: Antecedents, Development, Measurement, and Outcomes. New York: Springer; 2007.
Hojat M, Gonnella JS, Nasca TJ, et al.: Physician empathy: definition, components, measurement, and relationship to gender and specialty. Am J Psychiatry 2002, 159:1561–1569.
Hojat M, Mangione S, Kane GC, Gonnella JS: Relationships between scores of the Jefferson Scale of Physician Empathy [JSPE] and the Interpersonal Reactivity Index [IRI]. Med Teach 2005, 27:625–628.
Larson EB, Yao X: Clinical empathy as emotional labor in the patient-physician relationship. JAMA 2005, 293:1100–1106.
Gallagher RM: Empathy: a timeless skill for the pain medicine toolbox. Pain Med 2006, 7:213–214.
Benbassat J, Baumal R: What is empathy, and how can it be promoted during clinical clerkships? Acad Med 2004, 79:832–839.
DasGupta S, Charon R: Personal illness narratives: using reflective writing to teach empathy. Acad Med 2004, 79:351–356.
Kern DE, Branch WT, Jackson JL, et al.: Teaching the psychosocial aspects of care in the clinical setting: practical recommendations. Acad Med 2005, 80:8–20.
Grezes J, Decety J: Functional anatomy of execution, mental simulation, observation, and verb generation of actions: a meta-analysis. Hum Brain Mapp 2001, 12:1–19.
Jackson PL, Lafleur MF, Malouin F, et al.: Potential role of mental practice using motor imagery in neurologic rehabilitation. Arch Phys Med Rehabil 2001, 82:1133–1141.
Singer T, Seymour B, O’Doherty JP, et al.: Empathic neural responses are modulated by the perceived fairness of others. Nature 2006, 439:466–469.
Orlinsky DE, Grawe K, Parks BK: Process and outcome in psychotherapy. In Handbook of Psychotherapy and Behavior Change, edn 4. Edited by Garfield SL. New York: Wiley; 1994:270–378.
Bohart AC, Elliott R, Greenberg LS, Watson JC: Empathy. In Psychotherapy Relationships that Work: Therapist Contributions and Responsiveness to Patients. Edited by Norcross JC. New York: Oxford University Press; 2002:89–108.
Hassenstab J, Dziobek I, Rogers K, et al.: Knowing what others know, feeling what others feel: a controlled study of empathy in psychotherapists. J Nerv Ment Dis 2007, 195:277–281.
Marci CD, Ham J, Moran E, Orr SP: Physiologic correlates of perceived therapist empathy and social-emotional process during psychotherapy. J Nerv Ment Dis 2007, 195:103–111.
Carmel S, Glick SM: Compassionate-empathic physicians: personality traits and social-organizational factors that enhance or inhibit this behavior pattern. Soc Sci Med 1996, 43:1253–1261.
DiBlasi Z, Harkness EE, Georgiou A, Kleijnen J: Influence of context effect on health outcomes: a systematic review. Lancet 2001, 357:762.
Halpern J: From Detached Concern to Empathy: Humanizing Medical Practice. New York: Oxford University Press; 2001.
Batalden P, Leach D, Swing S, et al.: General competencies and accreditation in graduate medical education. Health Aff 2002, 12:103–111.
Detmar SB, Muller MJ, Wever LDV, et al.: Patient-physician communication during outpatient palliative treatment visits: an observational study. JAMA 2001, 285:1351–1357.
Roter DL, Hall JA, Kern DE, et al.: Improving physicians’ interviewing skills and reducing patients’ emotional distress. A randomized clinical trial. Arch Intern Med 1995, 155:1877–1884.
Kaplan SH, Greenfield S, Ware JE: Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care 1989, 27(Suppl):S110–S127.
Stewart MA: Effective physician-patient communication and health outcomes: a review. CMAJ 1996, 152:1423–1433.
Tamblyn R, Abrahamowicz M, Dauphinee D, et al.: Physician scores on a national clinical skills examination as predictors of complaints to medical regulatory authorities. JAMA 2007, 298:993–1001.
Brown JB, Boles M, Mullooly JP, Levinson W: Effect of clinician communication skills training on patient satisfaction: a randomized, controlled trial. Ann Intern Med 1999, 131:822–829.
Fiscella K, Meldrum S, Franks P, et al.: Patient trust: is it related to patient-centered behavior of primary care physicians? Med Care 2004, 42:1049–1055.
Kaplan SH, Greenfield S, Gandek B, et al.: Characteristics of physicians with participatory decision-making styles. Ann Intern Med 1995, 124:497–504.
Stewart M, Brown JB, Donner A, et al.: The impact of patient-centered care on outcomes. J Fam Pract 2000, 49:796–804.
Beach MC, Rosner M, Cooper LA, et al.: Can patient-centered attitudes reduce racial and ethnic disparities in care? Acad Med 2007, 82:193–198.
Banja JD: Empathy in the physician’s pain practice: benefits, barriers, and recommendations. Pain Med 2006, 7:265–275.
Goubert L, Craig KD, Vervoort T, et al.: Facing others in pain: the effects of empathy. Pain 2005, 118:285–288.
Frantsve LM, Kerns RD: Patient-provider interactions in the management of chronic pain: current findings within the context of shared medical decision making. Pain Med 2007, 8:25–35.
Chang Y, Lin YP, Chang HJ, Lin CC: Cancer patient and staff ratings of caring behaviors: relationship to level of pain intensity. Cancer Nurs 2005, 28:331–339.
Schupp CJ, Berbaum K, Berbaum M, Lang EV: Pain and anxiety during interventional radiologic procedures: effect of patients’s state anxiety at baseline and modulation nonpharmacologic analgesia adjuncts. J Vasc Interv Radiol 2005, 16:1585–1592.
Tait RC, Chibnall JT: Effect of treatment success and empathy on surgeon attributions for back surgery outcomes. J Behav Med 2005, 28:301–312.
Kalauokalani D, Franks P, Oliver JW, et al.: Can patient coaching reduce racial/ethnic disparities in cancer pain control? Secondary analysis of a randomized controlled trial. Pain Med 2007, 8:17–24.
Holmes-Rovner M, Nelson WL, Pignone M, et al.: Are patient decision aids the best way to improve clinical decision making? Report of the IPDAS Symposium. Med Decis Making 2007, 27:599–608.
About this article
Cite this article
Tait, R.C. Empathy: Necessary for effective pain management?. Current Science Inc 12, 108–112 (2008). https://doi.org/10.1007/s11916-008-0021-6
- Empathic Concern
- Emotional Labor
- Communication Skill Training
- Interventional Radiologic Procedure
- Interpersonal Reactivity Index