What Is Empathy?

  • Zimri S. YaseenEmail author
  • Adriana E. Foster


We propose empathy to be the process of relating to another in a mode that facilitates the creative elaboration of mutual understanding and recognition. The empathic mode thus presupposes both commonality and difference as it seeks the development of a common language—a shared network of meanings, allowing one to see beyond pre-existing commonalities and create new ones. In this chapter, we elaborate this understanding of the nature of empathy to contextualize the bio-behavioral underpinnings of commonality and the innate capacities we have for bridging difference. Finally, we discuss barriers to and breakdowns of the empathic mode such as cultural difference, dehumanization, and stigma.


Empathy Compassion Cognitive empathy Emotional empathy 


  1. 1.
    Nussbaum, M. C. (1994). Patriotism and cosmopolitanism. Boston Review, 19(5). See Retrieved October 01, 2010, from
  2. 2.
    Germer, C. K., & Siegel, R. D. (2012). Wisdom and compassion in psychotherapy: Deepening mindfulness in clinical practice. New York: Guilford Press.Google Scholar
  3. 3.
    Vischer, R. (1873). On the optical sense of form: A contribution to aesthetics. Empathy, Form, and Space: Problems in German Aesthetics, 1893, 89–124.Google Scholar
  4. 4.
    Ganczarek, J., Hünefeldt, T., & Olivetti Belardinelli, M. (2018). From “Einfühlung” to empathy: Exploring the relationship between aesthetic and interpersonal experience. Cognitive Processing, 19(2), 141–145.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Lanzoni, S. (2009). Practicing psychology in the art gallery: Vernon Lee’s aesthetics of empathy. Journal of the History of the Behavioral Sciences, 45(4), 330–354.PubMedCrossRefGoogle Scholar
  6. 6.
    James, W. (1894). Discussion: The physical basis of emotion. Psychological Review, 1(5), 516.CrossRefGoogle Scholar
  7. 7.
    Lanzoni, S. (2012). Empathy in translation: Movement and image in the psychological laboratory. Science in Context, 25(3), 301–327.CrossRefGoogle Scholar
  8. 8.
    Titchener, E. B. (2014). Introspection and empathy. Dialogues in Philosophy, Mental & Neuro Sciences, 7(1), 25–30.Google Scholar
  9. 9.
    Haslam, N. (2007). Humanising medical practice: The role of empathy. Medical Journal of Australia, 187(7), 381–382.PubMedCrossRefGoogle Scholar
  10. 10.
    Carl Rogers On Empathy. (1974). Distinguished contributors to counseling film series: American Personnel and Guidance Association.Google Scholar
  11. 11.
    Gendlin, E. T. (1991). On emotion in therapy. Emotion, psychotherapy, and change (pp. 255–279). London: Guilford.Google Scholar
  12. 12.
    Decety, J. (2015). The neural pathways, development and functions of empathy. Current Opinion in Behavioral Sciences, 3, 1–6.CrossRefGoogle Scholar
  13. 13.
    Singh, P., Raffin-Bouchal, S., McClement, S., Hack, T. F., Stajduhar, K., Hagen, N. A., et al. (2018). Healthcare providers’ perspectives on perceived barriers and facilitators of compassion: Results from a grounded theory study. Journal of Clinical Nursing, 27(9–10), 2083–2097.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Rāhula, W. (1974). What the Buddha taught. New York: Grove Press.Google Scholar
  15. 15.
    Neumann, M., Bensing, J., Mercer, S., Ernstmann, N., Ommen, O., & Pfaff, H. (2009). Analyzing the “nature” and “specific effectiveness” of clinical empathy: A theoretical overview and contribution towards a theory-based research agenda. Patient Education and Counseling, 74(3), 339–346.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Preston, S. D., & De Waal, F. B. (2002). Empathy: Its ultimate and proximate bases. Behavioral and Brain Sciences, 25(1), 1–20.CrossRefGoogle Scholar
  17. 17.
    Cattaneo, L., & Rizzolatti, G. (2009). The mirror neuron system. Archives of Neurology, 66(5), 557–560.CrossRefGoogle Scholar
  18. 18.
    Morse, J. M., Anderson, G., Bottorff, J. L., Yonge, O., O’Brien, B., Solberg, S. M., et al. (1992). Exploring empathy: A conceptual fit for nursing practice? Image: The Journal of Nursing Scholarship, 24(4), 273–280.Google Scholar
  19. 19.
    Blanke, E. S., Rauers, A., & Riediger, M. (2016). Does being empathic pay off?—Associations between performance-based measures of empathy and social adjustment in younger and older women. Emotion, 16(5), 671.PubMedCrossRefGoogle Scholar
  20. 20.
    Mercer, S. W., & Reynolds, W. J. (2002). Empathy and quality of care. British Journal of General Practice, 52(Suppl), S9–S12.PubMedGoogle Scholar
  21. 21.
    Tavakol, S., Dennick, R., & Tavakol, M. (2012). Medical students’ understanding of empathy: A phenomenological study. Medical Education, 46(3), 306–316.CrossRefGoogle Scholar
  22. 22.
    McDonald, L. (2017). Florence Nightingale, nursing, and health care today. New York: Springer Publishing Company.CrossRefGoogle Scholar
  23. 23.
    Hojat, M., Gonnella, J. S., Nasca, T. J., Mangione, S., Vergare, M., & Magee, M. (2002). Physician empathy: Definition, components, measurement, and relationship to gender and specialty. American Journal of Psychiatry, 159(9), 1563–1569.CrossRefGoogle Scholar
  24. 24.
    Sonnby–Borgström, M. (2002). Automatic mimicry reactions as related to differences in emotional empathy. Scandinavian Journal of Psychology, 43(5), 433–443.PubMedCrossRefGoogle Scholar
  25. 25.
    Kunyk, D., & Olson, J. K. (2001). Clarification of conceptualizations of empathy. Journal of Advanced Nursing, 35(3), 317–325.PubMedCrossRefGoogle Scholar
  26. 26.
    Salovey, P., & Mayer, J. D. (1990). Emotional intelligence. Imagination, Cognition and Personality, 9(3), 185–211.CrossRefGoogle Scholar
  27. 27.
    Bylund, C. L., & Makoul, G. (2002). Empathic communication and gender in the physician–patient encounter. Patient Education and Counseling, 48(3), 207–216.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Alligood, M. R. (1992). Empathy: The importance of recognizing two types. Journal of Psychosocial Nursing and Mental Health Services, 30(3), 14–17.PubMedCrossRefGoogle Scholar
  29. 29.
    Stewart, M. A. (1995). Effective physician-patient communication and health outcomes: A review. CMAJ: Canadian Medical Association Journal, 152(9), 1423.PubMedGoogle Scholar
  30. 30.
    Rakel, D., Barrett, B., Zhang, Z., Hoeft, T., Chewning, B., Marchand, L., et al. (2011). Perception of empathy in the therapeutic encounter: Effects on the common cold. Patient Education and Counseling, 85(3), 390–397.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Hojat, M., Louis, D. Z., Markham, F. W., Wender, R., Rabinowitz, C., & Gonnella, J. S. (2011). Physicians’ empathy and clinical outcomes for diabetic patients. Academic Medicine, 86(3), 359–364.PubMedCrossRefGoogle Scholar
  32. 32.
    Del Canale, S., Louis, D. Z., Maio, V., Wang, X., Rossi, G., Hojat, M., et al. (2012). The relationship between physician empathy and disease complications: An empirical study of primary care physicians and their diabetic patients in Parma, Italy. Academic Medicine, 87(9), 1243–1249.PubMedCrossRefGoogle Scholar
  33. 33.
    Mercer, S. W., Higgins, M., Bikker, A. M., Fitzpatrick, B., McConnachie, A., Lloyd, S. M., et al. (2016). General practitioners’ empathy and health outcomes: A prospective observational study of consultations in areas of high and low deprivation. The Annals of Family Medicine, 14(2), 117–124.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Graber, M. L., Franklin, N., & Gordon, R. (2005). Diagnostic error in internal medicine. Archives of Internal Medicine, 165(13), 1493–1499.PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Mauksch, L. B., Dugdale, D. C., Dodson, S., & Epstein, R. (2008). Relationship, communication, and efficiency in the medical encounter: Creating a clinical model from a literature review. Archives of Internal Medicine, 168(13), 1387–1395.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    West, C. P., Huschka, M. M., Novotny, P. J., Sloan, J. A., Kolars, J. C., Habermann, T. M., et al. (2006). Association of perceived medical errors with resident distress and empathy: A prospective longitudinal study. Journal of the American Medical Association, 296(9), 1071–1078.PubMedCrossRefPubMedCentralGoogle Scholar
  37. 37.
    Forgiarini, M., Gallucci, M., & Maravita, A. (2011). Racism and the empathy for pain on our skin. Frontiers in Psychology, 2, 108.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Zaki, J., & Cikara, M. (2015). Addressing empathic failures. Current Directions in Psychological Science, 24(6), 471–476.CrossRefGoogle Scholar
  39. 39.
    Hojat, M., Vergare, M. J., Maxwell, K., Brainard, G., Herrine, S. K., Isenberg, G. A., et al. (2009). The devil is in the third year: A longitudinal study of erosion of empathy in medical school. Academic Medicine, 84(9), 1182–1191.PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Brazeau, C. M., Schroeder, R., Rovi, S., & Boyd, L. (2010). Relationships between medical student burnout, empathy, and professionalism climate. Academic Medicine, 85(10 Suppl), S33–S36.PubMedCrossRefGoogle Scholar
  41. 41.
    Quince, T., Thiemann, P., Benson, J., & Hyde, S. (2016). Undergraduate medical students’ empathy: Current perspectives. Advances in Medical Education and Practice, 7, 443–455.PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Mol, A. (2008). The logic of care: Health and the problem of patient choice. Abingdon: Routledge.CrossRefGoogle Scholar
  43. 43.
    Jeffrey, D. (2016). A meta-ethnography of interview-based qualitative research studies on medical students’ views and experiences of empathy. Medical Teacher, 38(12), 1214–1220.CrossRefGoogle Scholar
  44. 44.
    Handford, C., Lemon, J., Grimm, M. C., & Vollmer-Conna, U. (2013). Empathy as a function of clinical exposure--reading emotion in the eyes. PLoS One, 8(6), e65159.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The “Reading the Mind in the Eyes” test revised version: A study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, 42(2), 241–251.PubMedCrossRefGoogle Scholar
  46. 46.
    Gruhn, D., Rebucal, K., Diehl, M., Lumley, M., & Labouvie-Vief, G. (2008). Empathy across the adult lifespan: Longitudinal and experience-sampling findings. Emotion, 8(6), 753–765.PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Pedersen, R. (2010). Empathy development in medical education--A critical review. Medical Teacher, 32(7), 593–600.PubMedPubMedCentralCrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral HealthIcahn School of Medicine, Mount Sinai Beth IsraelNew YorkUSA
  2. 2.Department of Psychiatry and Behavioral HealthHerbert Wertheim College of Medicine, Florida International UniversityMiamiUSA

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