Empathy is Not Enough

empathic therapyEmpathy can be seen as the matching of feelings or the matching of minds. It can reflect compassion, recognition and communion. It reflects an emotional understanding of another person’s feelings or problems. The ability to be empathetic can be a positive characteristic which brings people closer together.

In psychotherapy, empathy is critical. It allows the therapist to meet patients where they are, to enter their world and understand what it feels like to be them. Empathy is important in forming a bond and in starting a working alliance with a therapist. It leads to warmth, compassion, caring, and concern.

Patients need empathy. A therapist who has trouble being empathetic, whether for personal or theoretical reasons, is lacking something critical which will limit his work. When a therapist has an inability to make an emotional connection or feel empathetic, he or she will be overly detached, cold, and clinical. This provides little sense of safety, which is a prerequisite for any effective therapy to take place. A patient’s perceptions of the therapist as empathetic is necessary in helping the patient stay in treatment and feel comfortable enough to stick out the sometimes painful experiences that come up as therapy progresses.

Unfortunately, empathy alone may not be enough. While it can help a patient feel supported and understood, it does not necessarily promote change. Having a therapist with an empathetic stance may be necessary, but it is not always sufficient to help a person grow.

Take the example of someone who has had a difficult life for any number of reasons. These factors need to be recognized, appreciated, and understood. However, if in reacting to present-day problems the patient reflexively takes the stance that he is helpless, having little sense of his own role in his current distress and suffering, empathy alone may not be enough to help him change. If the therapist expresses nothing but warmth and empathy it may feel good to the patient but it can also support the problems rather than help resolve them.

Let’s say a recurring theme for the person is feeling the world is always unfair. He feels his girlfriend is always critical or his boss always blames him. Simply being empathetic may lead him to feel understood and validated, but that doesn’t necessarily lead to change. At times, it may be important to challenge patients’ view of themselves and point out ways in which they have a part in bringing about the problems that lead them to suffer. At times it is important for a therapist to stand firm, even when the patient protests. Having another person stay grounded, firm, and steady without becoming punitive may be a new experience for the person, and just what is needed in order to grow. It can also give a person the space to express suppressed angry feelings with the therapist who is grounded and steady.

Patients who have been seriously traumatized may need a long period of empathetic support to provide a corrective emotional experience. There are people who must experience what they never had in order to go on in life — for example, people who grew up in a very abusive or cold environment. Beyond this, everyone needs to feel a baseline of care and support, just not at the expense of sometimes being challenged to change.

The problem is that a compulsion on the part of a therapist to be exclusively empathetic can reflect issues with the therapist’s boundaries and reflect his or her need to be overly involved. If the therapist always has to rush in and attempt to save a person from any and all distress, it can block a person’s growth. A therapist with his own boundary issues may be too concerned with being approved or liked by his patient, and find it overly important to see himself as a caring person. This is clearly being overly enmeshed and will sometimes even recreate what led to a person’s problems, and present yet another bad model.

Article Name
Empathy is Not Enough
Empathy is critical for a patient's sense of safety, but an effective therapist knows when empathy alone isn't enough, and can provide a firm, grounded, steady approach to help the patient grow.

About Marc Handelman, PhD

I am a licensed clinical psychologist practicing in New York City. My office is located on the Upper West Side of Manhattan, near Columbia University. I work with adults from college age and up who want help addressing problems ranging from depression, anxiety, and relationship issues to addiction, co-dependency, and the effects of early trauma. I believe psychotherapy should provide a sense of comfort and support as the starting point for addressing emotional problems. I have more than 30 years' experience as a psychotherapist, and have been affiliated with The Hazelden Foundation since 1997. Please see my professional website for more information: http://www.psychotherapy-nyc.com
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