Two psychiatrists meet on the street. One says to the other, "You're fine, how am I?"

Empathy is currently one of the most discussed topics in psychology. Parental empathy seems central in nourishing the development of psychological health. Deficiencies in parental empathy are likely to be key factors in creating risks for personality disorders, interpersonal impairments and depression. In adults, lack of empathy is a contributing factor in perpetrating exploitive and abusive behavior. Clinicians consider empathy to be the most important element in the success of psychotherapy and blame failures in empathy for negative therapeutic outcomes.

In psychiatric terms, having empathy is defined as one person's ability to understand accurately the feeling state of another. This is different from sympathy which is usually understood as the inclination for one person to feel the same as another. Empathy is unique in that the feeling is not necessarily shared; an empathic person simply appreciates the feeling state of the other person. The origin of empathy seems to come from the physical "mirroring" that parents and other adults do with children. The effort on the part of the adult to mimic the child is the first stage of the ongoing effort to put aside one's thoughts and feelings in order to recognize and communicate understanding of what a child feels. As the author Alice Miller says, "If a child is lucky enough to grow up with a mirroring mother…who is at the child's disposal…then a healthy self-feeling can generally develop in the growing child." Parental empathy generates a sense of self understanding and self esteem which are crucial to psychological adjustment. When empathy is persistently absent, the child must adapt. For example, a child may learn to reject his/her particular feeling that resulted in crying when the tears provoke anxiety in the parent. Frequently, we see the results of this in clients who don't recognize their own feeling states - be it sadness or anger or other feelings - but are hypersensitive to disapproval and other negative reactions in others.

We have all experienced frustration and pain as we interact with those who spend much of their lives seeking what they did not receive from their parents, in this case "seeking mirroring." When the need to be understood takes precedence over mutuality in social situations, social interchanges can feel like a one-way street patrolled by an angry police officer. The need for recognition and understanding can be so intense that it may be experienced by others as demanding and self-centered. Is it any wonder that this stance frequently provokes discord and rejection and then becomes another example of "not being understood?"

Hidden behind the anger in a person "seeking mirroring" is
the child who fears that the search will be in vain. Herein lies the risk for depression: the adult once again experiences the pain of not being understood - of not receiving empathy. The loneliness of the moment may be expressed as anger but the expectation of chronic disappointment will create the risk for enduring depression. For those who have histories of being raised by caregivers who lacked empathy, the pursuit of empathy as an adult may be chronically in vain because even slight failures in empathy from an important other are powerfully reminiscent of childhood and convincing evidence that the possibility of an empathic friend, therapist, or spouse is nonexistent.

Lack of empathy, when present in its extreme form, allows people to exploit others without remorse. One client remarked that his counselee's resistance to his sexual overtures seemed to him just a way of being "coy" and leading him on. Sometimes clients who have been abused report how, as a child, they were paralyzed with fear by the sexual touch of an adult while adult child molesters have remarked that it couldn't have been so bad for the child because "he didn't say anything."

Clinicians consider the role of impaired empathy in sexual exploitation disorders so critical to the abuse, that empathy training is often a central component in the psychological treatment of these disorders. Clients read or hear testimony from victims about the experience of being sexually exploited as a way of impressing on a client what it feels like to be victimized. Although these techniques seem like useful methods of eliciting empathy for the victim, some mental health professionals argue that the client can only feel empathy for his victims if he has first experienced empathy for his own past hurts. Thus, treatment often includes getting in touch with the perpetrator's own pain.

For those involved in ministering to others, empathy is a necessary skill. Men and women in ministry typically have strong empathic abilities. Nevertheless, there are pitfalls in practicing empathy. A common mistake occurs when a minister assumes he or she knows how another person is feeling because, "that's how I would feel" in a similar situation. "How I would feel" may or may not be the same as how another person feels. Misassumptions could lead to trying to rescue people who aren't in need and don't want help. We have all seen how this can lead to frustration and even burnout. Ultimately, accurate empathy depends on genuine curiosity about the other person and recognition of their feelings; this helps establish the groundwork for accurate communication and effective ministry.

Stephen Montana, Ph.D. is the Director of Clinical Services at Saint Luke Institute

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