a rumor of empathy: what empathy is and how it makes a ...€¦ · • compassion – altruism –...

Arumorofempathy:Whatempathyisandhowitmakesadifference

LouAgosta,PhDNorthwesternFeinbergSpecialLecture

[email protected],2016

DavidHume:4DefiniOonsofSympathy(1739)•  EmoOonalcontagion•  SuggesObility•  DoublerepresentaOon:animpressionofyourimpression

•  ADelicacyofsympathyandtaste

•  Benevolence

(c)LouAgosta,PhD,[email protected] 2

Thesecretundergroundhistoryofempathy

•  Hume’sdefiniOonsof“sympathy”andtaste•  Kant’s“communicabilityofaffect”and“enlargedthinking”–changeperspecOves

•  Lipps’projecOveandaestheOcempathy•  Freud’sencounterwithLipps•  ThedebunkingofLippsbythephenomenologistsScheler,Stein,Husserl

•  RogersandKohut(empathynolongerasecret)(c)LouAgosta,PhD,

[email protected] 3

EmpathicRecep,vity[agraciousandgenerouslistening]

EmpathicUnderstanding[breakthroughtopossibility]

EmpathicInterpreta,on[“topdown”folkpsychologytheviewfrom“overthere”]

EmpathicResponsiveness[narra,ve:themovieofone’slife]

HowempathyfuncOons…


EmpathicRecep,vity[emo,onalcontagion/panic]

EmpathicUnderstanding[projec,on/Labeling/applyingcategories–

stereotyping]

EmpathicInterpreta,on[mis-interpreta,on:

takethingsoutofcontext/un-charitable/secondguessing]

EmpathicResponsiveness[thoughtlessremarks/gossip/emptytalk

Blame/finger-poin,ng/“Mondaymorningquarter-backing”]

HowEmpathyBreaksdown/Fails


[1]

[2][3]

[4]

Ontologyandphenomenology:TheshortdefiniOonofempathy…

•  BeinginthepresenceofanotherhumanbeingwithouttheaddiOon[interposiOon]ofcategories,labels,diagnoses,judgments,evaluaOons

•  Theexperienceofrelatedness…


Four(4)examplesfromliterature

•  ThomasMann/emoOonalcontagion•  ThomasMann/possibilityorcompassion•  EdmundRostrand(CyranodeBergerac)/egocentrism–projecOon

•  TennesseeWilliams/Responsiveness


EmpathyandintrospecOon

•  Ifonegoesfarenoughinward,thenonefindstheother

•  Itisamyththatweareunrelated–weareallrelated–andthephilosopherDescartes’thoughtexperimentofanisolatedconsciousness,disconnectedfromtheworldmissedtherelatednesstotheotherthatmakespossibleconsciousnessaltogether


EmpathyandintrospecOon

•  MyreacOontotheotherperson–annoyance,affecOon,hosOlity,boredom,compassion,love,hatred,fear,sadness–tellsmeasmuchaboutmyselfasitdoesabouttheother

•  ReflecOonononeselfandone’sownissuesisrequiredtounderstandtherelaOonship


Empathyandcompassion/altruism

•  Empathytellsmewhattheotherpersonisexperiencing

•  Compassion–altruism–goodupbringing–training–tellonewhattodoaboutit

•  NoparOcularformofacOonorbehaviorisarequiredconsequenceofempathy

•  Empathicresponsivenessisanaspectofempathyandgivestheotherpersontheirownexperiencebackinaformthattheyrecognizeastheirown


Empathyasfilterofvariablegranularity

•  Iftheotherpersonissufferingandyouhaveavicariousexperienceofthesuffering,thenyouaregoingtosuffer–butstrangeasitsounds,nottoomuch

•  Ifyouareoverwhelmedbythesuffering,youaredoingitwrong–youshouldsuffer,butstrangeasitsounds,nottoomuch

•  That’sthetraining…


ExampleofthegoodSamaritan

•  TheLeviteandthePriestwhopassbyexperiencedEmpathicDistress–

•  TheSamaritanrecognizedthesufferingofthesurvivoroftheassault–hehadavicariousexperience–atraceaffect–asampleoftheother’sexperience

•  Hisempathytoldhimwhattheotherwasexperiencing–hisneighborlinesstoldhimwhattodoaboutit



Whatdoesitmeantotrainempathy?Removeobstaclessuchascategorizing

people,labeling,pigeon-holing

Whatdoesitmeantotraininempathy?

•  Mostpeoplearenaturallyempathic•  Empathyisstopped,limited,reduced,constrainedby:shame,guilt,fear,judgments,blame,evaluaOons,authority,hierarchy,lowself-esteem,egocentrism,projecOon,resignaOon,narcissism,cynicism,denial…

•  Removetheobstaclestoempathy,andempathynaturallyunfolds,showsup,develops

•  ThisdoesnotincludeOpsandtechniquesthatcaninduce,promote,sOmulateempathy


SummaryandTakeAways

•  Weengagedwith– ThehistoryofempathyinHume,Kant,Lipps,Freud,thephenomenologists

– Examplesofempathyandempathicbreakdowns(failures)inliterature

– ThedisOncOonbetweenempathyandcompassion– EmpathyandintrospecOon–empathyasafilteragainstcompassionfaOgue


AddiOonalTalkingPoints

•  Thefollowingslidescoverfurtherdetailson– ThehistoryofempathyinHume,Kant,Lipps,Freud,thephenomenologists

– Examplesofempathyandempathicbreakdowns(failures)inliterature

– PeerreviewedjournalarOclesontheimpactofempathyonlifestylediseases(e.g.,diabetes2)andthecommoncold

– Exercise(s)andmiscellaneoustalkingpoints


DavidHume(1711–1776)

•  ‘Tisindeedevident,thatwhenwesympathizewiththepassionsandsenOmentsofothers,thesemovementsappearatfirstinourmindasmereideas,andareconceiv’dtobelongtoanotherperson,asweconceiveanyothermaneroffact.‘Tisalsoevident,thattheideasoftheaffecOonsofothersareconvertedintotheveryimpressionstheyrepresent,andthatthepassionsariseinconformitytotheimagesweformofthem(1739:319-20).

(c)LouAgosta/[email protected] 17

Hume’sideasandimpression


impression(s)Ideaofanger

one’simpressionoftheanger

[drawingnottoscale]

(1) convert:impressiontoidea[understanding](2) convert:ideatoimpression[sympathy/(imagina,on)]

(1)

(2)

Hume’sideasandimpression


impression(s)Ideaofanger

one’simpressionoftheanger

[drawingnottoscale]

(1) convert:impressiontoidea[understanding](2) convert:ideatoimpression[sympathy/(imagina,on)]

TheimaginaOon:TransposingperspecOvesandgeneraOngsympathy


Theguywithumbrellasays:“WeneededRain.”Theimagina,onisresponsiblefor(1) Conver,ngideastoimpressionsin

Sympathy(2) Changingperspec,ves“asif”Iwere“over

there”(3) Adis-interestedspectatorisnotcold

hearted–lacksaconflictofinterest-mays,llbesympathe,c

(4) Falsebelieftest

Delicacyoftastevsdelicacyofpassion


Hume’sexampleofthecaskofsherry…IfyouareawareofsomethingofwhichIlackaware,thenyour“delicacy”ismorefine-grained

DavidHume

•  Everymovementofthetheatre,byaskillfulpoet,iscommunicated,asitwerebymagic,tothespectators;whoweep,tremble,resent,rejoice,andareinflamedwithallthevarietyofpassions,whichactuatetheseveralpersonagesofthedrama(1751:49).


DavidHume

•  Acheerfulcountenanceinfusesasensiblecomplacencyandserenityintomymind;asanangryorsorrowfulonethrowsasuddendampuponme.Hatred,resentment,esteem,love,courage,mirthandmelancholy;allthesepassionsIfeelmorefromcommunicaOonthanfrommyownnaturaltemperanddisposiOon(T2.1.11.2;1739:316-17).


DavidHume

•  SocloseandinOmateisthecorrespondenceofhumansoulsthatnosooneranypersonapproachesme,thanhediffusesonmeallhisopinions,anddrawsalongmyjudgmentinagreaterorlessdegree.Andtho’,onmanyoccasions,mysympathywithhimgoesnotsofarasenOrelytochangemysenOmentsandwayofthinking;yetitseldomissoweakasnottodisturbtheeasycourseofmythought...(T3.3.2.2;1739:592).


DavidHume•  ‘Tisremarkable,thatnothingtouchesamanofhumanitymorethananyinstanceofextraordinarydelicacyinloveorfriendship...Thepassionsaresocontagious,thattheypasswiththegreatestfacilityfromonepersontoanother,andproducecorrespondentmovementsinallhumanbreast.Wherefriendshipappearsinverysignalinstances,myhartcatchesthesamepassion,andiswarmedbythosewarmsenOments,thatdisplaythemselvesme(T3.3.3.5;1739:604-5).


Summary(Hume)

•  EmoOonalcontagion/suggesOon•  Conversionofideatoimpression•  Conversionofideatoimpression+TheOther•  Delicacyoftasteimpression•  Benevolence/compassion


ImmanuelKant

•  Liketaste,empathyisdisinterested•  Liketaste,empathyrequirestheuniversalcommunicabilityoffeelings

•  Liketaste,empathyleveragestheformofpurposiveness

•  Liketaste,empathyrelatesnecessarilytotheother


ArumorofempathyinKant

•  The“communicabilityoffeelings”(1790/93a:174;§40(AA294))soundslikesteponeofthemulO-dimensionalapproachtoempathy.

•  Kant’s“communicabilityoffeeling”isthecluetothereconstrucOonofthedeephistoryofempathyinKant.


Kant


(1)  FreeplayoftheimaginaOonandunderstanding(2)  SubordinaOonofsensibilitytoinfinitereason(3)  Distancing:dis-interestedness(4)  Engagement:communicabilityoffeeling(5)  Engagementwiththeother(sensuscommunis)(6)  Purposefulnessofthemanifold

(1)–(6)

ImmanuelKant(1790/93)

•  WecallbuildingsortreesmajesOcandmagnificent,orfieldssmilingandjoyful;evencolorsarecalledinnocent,modestortender,becausetheyarousesensaOonthatcontainsomethinganalogicaltotheconsciousnessofamentalstateproducedbymoraljudgments.TasteasitweremakespossiblethetransiOonfromsensiblecharmtothehabitualmoralinterestwithouttooviolentaleap[…](1790/93a:228;§59(AA354)).


Inaragingstormwhereistherage?


rage

one’simpressionoftherage

Kant–“subrepOon”=“projecOon”=

anerrorIjudgment


•  ...[T]heimaginaOoninitsfreedomarousestheunderstanding,andthelaner,withoutconcepts,setstheimaginaOonintoaregularplay[and]therepresentaOoniscommunicated,notasathought,butastheinnerfeelingofapurposivestateofmind.

•  Tasteisthusthefacultyforjudgingapriorithecommunicabilityofthefeelings[dieMi0eilbarkeitderGefühle]thatarecombinedwithagivenrepresentaOon(withoutthemediaOonofaconcept)(1790/93a:§40;175-176;(AA:296)).



•  Thisisthemomentfortopdown,cogniOveempathicinterpretaOon.Kantexplicitlynotesthiskindofcommonsenseenablesus–– “toputourselvesinthoughtintheplaceofeveryother”(1790/93b:§40;136;(AA293)(“…anderStellejedesanderendenken…”)).

– ThisenablesonetolinkbacktoempathicinterpretaOonandthelogicalfuncOoninvokedinsubsOtuOngathird-personforafirst-personperspecOve.


TheodorLipps(1851–1914)

•  Youknowhowthemovie/playAmadeusshowedthatAntonioSalieriwasfamousinhisdayandisnowunknownincomparisonwithMozart?

•  LippswastheSalieriof“empathy,”dominaOngthetermupunOl1914andbeyondwhereastodayheisunknown


TheodorLipps(1885/1903)

•  LippssubsOtutes“empathy”for“aestheOctaste”•  Weprojectour“feelingofvitalityandemoOons”intonatureandintootherpeople

•  Lippsisfamousinhisday–and“owns”theword“empathy”[einfühlung]

•  Lipps’“projecOveempathy”becomesthe“target”ofthecriOquebythephenomenologistsScheler,Husserl,Stein,andHeidegger[whichbringsustothepresent]


TheodorLipps

•  OnlyinsofarasthisempathyexistsareformsbeauOful.TheirbeautyisthisidealfreedomwithwhichIexpresslife[Sichausleben]inthem.Conversely,formisuglywhenIamunabletodothis,whenIfeelunfreeinwardly,inhibited,subjectedtoconstraintwithregardtoform,orinregardtoitscontemplaOon(1903:247).


TheodorLipps

•  Infull,posiOveempathyonlyoneindividualegoexistsforme;namelythisempathizedorobjecOfiedownego,whichisprojectedintoanexternalobject(1909:194).


TheodorLipps

•  IninnerimitaOonthereisnoseparaOonbetweentheacrobatupaboveandmebelow.Onthecontrary,IidenOfymyselfwithhim.Ifeelmyselfinhimandinhisplace....


TheodorLipps

•  InsuchinnerimitaOonIdischarge—notthemoOonswhichtheacrobatdischarges—ratherIdischargeimmediately,orinwardly,orinthought,themoOonsoftheacrobat.IdischargethemoOonsinsofarasthisdischargeofmoOonisnotanexternalbutaninneractintheacrobathimself(1903:121-122).


TheodorLipps

•  IninnerimitaOonthereisnoseparaOonbetweentheacrobatupaboveandmebelow.Onthecontrary,IidenOfymyselfwithhim.Ifeelmyselfinhimandinhisplace....

•  Inempathy,therefore,Iamnottherealego[ich]butaminwardlyliberatedfromthelaner,i.e.,IamliberatedfromeverythingwhichIamapartfromthecontemplaOonofform.Iamonlythisideal,thiscontemplaOngego(1903:247).


TheodorLipps

•  The“other”isone’sownpersonality,amodifiedownego,whichisrepresentedandmodifiedaccordingtotheexternalappearanceandthepercepObleexpressionsoflife.Themanbesidesme,ofwhichIamconscious,isaduplicateandatthesameOmeamodificaOonofmyself.(1903:106).


TheodorLipps

•  ThefirstmaterialandoccasionfortheconstrucOonoftheforeignpersonalityisofferedbyhisexpressionoflife,theaudibleandvisible,thesoundsandphysiognomyorgesture,inshort,theexpressivemovements(1903:106).


TheTangle

•  Lippsownstheterm“empathy”•  Noonecanusethewordwithoutappearingtobeastudentofempathy–but…

•  Freudishisownman•  Thephenomenologists–MaxScheler,EdithStein,EdmundHusserl,MarOnHeidegger–argueagainstLipps’theoryof“projecOveempathy”


MaxScheler(1874–1928)

•  Itisperfectlymeaningfultosay:“Icanfeelforyouvicariously,butIhavenopity[“Mitleid”]foryou.”Such“vicariousfeeling”remainswithinthecogniOvesphere,andisnotamorallyrelevantact.ThehistorianofmoOves,thenovelist,theexponentofthedramaOcarts,mustallpossessinhighdegreethegivofvicariousfeeling.Butthereisnottheslightestneedforthemtosharethefeelingsoftheirsubjectsandpersonages(1912/22:9).


MaxScheler

•  ...Neither“projecOveempathy”nor“imitaOon”isnecessaryinordertoexplaintheprimarycomponentsofsharedfeeling,namely,understandingandvicariousfeelingand[vicarious]life[NachfühlenundNachleben]1912/22).

•  “ImitaOon”is“Nachahmung”(“ahmen”means“tomeasure,”usuallyanamountofliquid),whileonceagain“sharedfeeling”translates“Mitgefühl.”


SigmundFreud

•  Freud’slenertoWilhelmFliess(August31,1898):

•  InLippsIhaverediscoveredmyownprinciplesquiteclearlystated–perhapsrathermoresothansuitedme.“Thereaderovenfindsmorethanheseeks.”Lippsregardsconsciousnessasonlyasenseorgan,thecontentsofthemindasideaOon,andallmentalprocessesasunconscious(Freud1887/1902:262-263).


EdmundHusserl(1859-1938)

•  Everyegoisa“monad.”Butthemonadshavewindows.Theydonothavewindowsordoorsthroughwhichothersubjectscanliterally[reel]getin—thewindowsareinstancesofempathy—butratherthroughwhichotherscangetthroughandbeexperiencedinawaysimilartoone’sownpastremembrances(HusserlXIV:260)....


EdmundHusserl

•  Amonadthushaswindowsinordertoreceiveforeignimpressions[fremdeEinwirkungen].Thewindowsareempathy(HusserlXIV:295)....


EdmundHusserl

•  Inonemonad,otherindividualmonadsare“directly”mirroredthroughempathy….Thustheotheregoanditspsycheannouncesitselfinme,andIannouncemyselfinit:Wearerelatedtooneanotherconsciouslyandknowaboutoneanother:and,thereby,everyoneofushasexperienceoftheotherbody[fremdleib]andapperceivesthisaccordingtoitsownbodyanalogicallyasbody(XIV:300).


•  Freud’slenertoWilhelmFliess(August31,1898):

•  InLippsIhaverediscoveredmyownprinciplesquiteclearlystated–perhapsrathermoresothansuitedme.“Thereaderovenfindsmorethanheseeks.”Lippsregardsconsciousnessasonlyasenseorgan,thecontentsofthemindasideaOon,andallmentalprocessesasunconscious(Freud1887/1902:262-263).


SigmundFreud

Freud

•  “ThedoctorwillcertainlyforfeitanyadvantagewhichhemighthaveinrelaOngtohispaOentifhebeginswithanyotherapproachthanempathy”[RecommendaOonsforPhysicians,1912]

•  22menOonsofEinfühlung[empath]in24volumesoftheStandardEdiOon–mostmis-translated


Trainspassinginthenight–simultaneousseparatediscovery(?)

•  CarlRogers:OnBecomingaPerson:uncondiOonalposiOveregard

•  HeinzKohut:vicariousintrospecOon,empathicbreakdowns[empathyviolaOons],andnarcissisOcrage

•  NoevidencethatRogersreadKohutorviceversa•  KohutwasprobablyreadingFerenczi,Baliant;Rogers,MarOnBuber[existenOalism],Niehbur,R.


4phasesofempathycapturemulOpledefiniOons

•  RecepOvity:Kohut:VicariousintrospecOon•  Understanding:Heidegger:Possibility•  InterpretaOon:FolkPsychology:Walkintheotherperson’sshoes

•  Responsiveness:DaliLama–prosocialbehavior:Loewald:givingthepersontheirownexperiencebackinwords


Detailedexamplesfromliterature…

•  ThomasMan:Buddenbrooks•  EdmundRostrand:CyranoDeBergerac•  TennesseeWilliams:TheGlassMenagerie


ExampleofempathicrecepOvity•  avigneneofempathicdistressinMann’scharacterofthedenOst,HerrDr.Brecht,whosewould-beempathyforhispaOentsmisfiresanddegeneratesintoemoOonalcontagionthatissuchthathe(Dr.Brecht)breaksoutinacoldsweatandhastositdownexhaustedavereachdentalprocedure.Inshort,Dr.Brechthasavailablethevicariousexperiencesthatwouldmakehimagoodempathizerifhewereabletocontrolthem;but,beingendowedwithanespeciallysensiOve,delicacyofempathy,insteadDr.Brechtfallspreytoempathicdistress.(ThomasMann.(1901).Buddenbrooks,tr.H.T.Lowe-Porter.NewYork:RandomHouse,1961:403–404.

•  )


ExampleofempathicrecepOvity•  Thebadthingabouthim[DrBrecht]washewasnervous,

anddreadedthetortureshewasobligedtoinflict.‘WemustproceedtoextracOon…,’hewouldsay,growingpale.Hannohimselfwasinapalecoldsweat,withstaringeyes,incapableofprotesOngorrunningaway;inshort,inmuchthesamecondiOonasacondemnedcriminal.HesawHerrBrecht,withtheforcepshissleeve,bendoverhim,andnoOcedthatlinlebeadswerestandingoutonhisbaldbrowandthathismouthwastwisted.Whenitwasallover,andHanno,paleandtrembling,spatbloodintothebluebasinathisside,HerrBrechttoohadtositdown,andwipehisforeheadandtakeadrinkofwater.”(ThomasMann.(1901).Buddenbrooks,tr.H.T.Lowe-Porter.NewYork:RandomHouse,1961:403–404.

•  )


Exampleofempathicunderstanding

•  SituaOon:ThomasisHanno’sfather–heisafrustratedarOstwhohaspursuedacareerinbusinesstosupporthisfamily–hisson,Hanno,isarOsOc–issicklywithbadteeth,getsbulliedinschoolandcanneverseemtosaOsfyhisfather’sdemandsforgoodgradesandakindof“Hailfellowwellmet!”a{tude

•  MeanwhileThomaswife,Gerda,isplayingpassionateviolinduosupstairswithherfriend,theLieutenant–themusicstops…longsilence…


Exampleofempathicunderstanding•  Buthisfatherdidnotseemtobelistening.HeheldHanno’sfreehandand

playedwithitabsently,unconsciouslyfingeringtheslimfingers.•  AndthenHannoheardsomethingthathadnothingtodowiththelesson

atall:hisfather’svoice,inatonehehadneverheardbefore,low,distressed,almostimploring;“Hanno—thelieutenanthasbeenmorethantwohourswithMamma.”

•  LinleHannoopenedwidehisgold-browneyesatthesound;andtheylooked,asneverbefore,clearlarge,andloving,straightintohisfather’sface,withitsreddenedeyelidsunderthelightbrows,itswhitepuffycheeksandlongsOffmoustaches.Godknowshowmuchheunderstood.Butonethingtheybothfelt:inthelongsecondwhentheireyesmet,allconstraint,coldness,andmisunderstandingmeltedaway.Hannomightfailhisfatherinallthatdemandedvitality,energyandstrength.ButwherefearandsufferingwereinquesOon,thereThomasBuddenbrookscouldcountonthetrustanddevoOonofhisson.Onthatcommongroundtheymetasone”(Buddenbrooks.(1901):507;modifiedslightly).


Exampleofempathicunderstanding

•  Theireyesmeet–anempathicmoment•  Thepossibilityofrelatednessbasedonvulnerability

•  Thefatherwhowassoinaccessiblebecomesvulnerableinhissuffering–Hanno“gets”hisvulnerability–thatis,hishumanity.

•  Ifempathicunderstandingbreaksdown,onegetsprojecOonoregocentrism–that’swhatwegetonthepartofThomaswhowantstomakeHanno“achipofftheoldblock”(c)LouAgosta,PhD,

[email protected] 59

EmpathicinterpretaOon

•  EdmondRostand’splayCyranodeBergerac,CyranogivesupthehopeofwinningtheloveofRoxannebecauseofhisunanracOvenose,theulOmatesymbolofhissocialawkwardness.InsteadCyranowoosRoxannevicariouslythroughthemoresuperficiallyanracOveChrisOan,bypu{nghimselfintheplaceofChrisOan–swappingroles–pu{nghisownskillsasapoetandnoblemanatChrisOan’sdisposal.


EmpathicinterpretaOon•  ChrisOanisreallyapuppetwhosestringsarebeingpulledbyCyrano,whohopesthatRoxanneseesthroughChrisOantotherealhumanitythatlieswithhim(Cyrano).

•  Alas,loveisblind,evenifempathyisnot.Cyrano’sempathicresponsivenessisrenderedineffecOvebybeingdisplacedfromexpressionsonhisownbehalftoexpressionsbenefiOngChrisOan,thepretender.Cyranomighthaverisentothelevelofempathy–heisrecepOveenoughtogathertherelevantexperiences–buthisempathyisinhibitedbyhislowself-esteemandsocialawkwardness.


Empathicresponsiveness

•  Breakdownsinempathicresponsivenessarecommon:gossip,changingthesubject,fingerpoinOng,blamingthevicOm,cheerfulnessinthefaceofdecidedlytraumaOcevents–nottomenOonmisuseoflanguageindecepOon,halftruths,andout-and-outlying…

•  Exampleofwhatnottodo[fortheguys]: “Youarejustlikeyourmother.”



•  Agoodexample:InTennesseeWilliam’sTheGlassMenagerie,Lauraisafragileisolatedyounglady–likehercollecOonofdelicateglassanimals–shewenttogradeschoolwithTomandhadacrushonhim–hecomestodinnerinnocentlyenoughattheinvitaOonofthemother,Amanda,althoughheisalreadyengagedtobemarried…Laurahadpleurisyasoneofherchildhoodillnessesandshewalkswithaslightlimp…



•  Tomcallsher“blueroses”–whichwashischildhoodmis-hearingoftheteachersayingshewassickandoutofschooldueto“pleurosis”

•  Lauradefinesherselfasthisdefect–aslightlimpthatishardlynoOceable–butasshewalksuptheaisleintheschoolauditoriumseemstomakeathunderousCLUMPinherownpercepOon



•  ItisabreakdownbecauseTomtriestogiveLaurabackherownexperienceoflowselfesteeminhisresponseof“blueroses”–notabrokengaitbutsomethingbeauOful

•  Itdoesnotworkforsomanyreasons–includingtheplaywrightscommitmenttohavingabrokenheartandemoOonaldevastaOon…


Exercise

(c)LouAgosta,[email protected] 66

Ican’thearyoubecauseIamconstantlytalkingtomyselfabout

whatyouaresaying

•  Nothowtolistenbener–howtoexpandone’slistening…

•  Walkingdownthestreet–commenOngonthepeople–what’sfordinner–whatuptomorrow–what’swrong–what’sright(etc.)

•  Stopandgiveitalisten….(c)LouAgosta,Ph.D.TheChicagoEmpathy

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Howtolisten

•  WhenapersondisOnguishesthenoiseandstatementsofthevoiceover,thenwhatislevisaspacetobewiththeotherpersonandlistentowhatsheorhehastosay

•  Thatistheempathicmoment–tojustbewiththeother–andrespondoutofnothing


TheDoctorasInstrument

•  Thedoctorhimself[herself]isapowerfultherapeuOcagent.InancientOmesthedoctorwasalmosttheonlyeffecOvetreatmentandmorerecentlyBalinthasdescribedthedoctorasthemostfrequentlyuseddrugingeneralpracOce.

-K.B.Thomas,TheConsultaOonandtheTherapeuOcIllusion,BriDshMedicalJournal20May1978[M.Balint,TheDoctor,HisPaDent,andtheIllness.TunbridgeWells:PinmanMeddical,1975.


Doctorschangethemeaningoftheterm“empathy”

•  Outsidethefieldofmedicine,empathyisamodeofunderstandingthatspecificallyinvolvesemoOonalresonance JodiHalpern,MD,PhD,“WhatisClinical Empathy?JGenInternMed2003Aug:18(8):670-674


ThebookthatgotmethrownoutoftheInsOtuteForPsychoanalysis

•  “Empathyisoxygenforthesoul.”

•  “Anyoneelseherefeelingshortofbreath?”

•  Terminated!•  Maybeoneneedsexpandedempathy!?

LOU AGOSTA

A RUMOR

of

EMPATHYResistance, narrative and

recovery in psychoanalysis


Empathyanddiabetes?!

•  PaOentsofphysicianswithhighempathyscoreswithsignificantlymorelikeleytohavegoodcontrolofhemoglobinA1c(56%)thanwerepaOentswithlowempathyscores(40%,P<.001).

•  M.Hojatetal,(2011),PhysiciansempathyandclinicaloutcomesfordiabeOcpaOents,ACADMEDMAR;86(3):359–64:doi:10.1097ACM.0b013e3182086fe1


Empathyandcholesterol?!

•  […]TheresultsoftheLDL-Ctestsgroupedintogoodcontrol(<100)andpoorcontrol(>130)[….]TheproporOonofpaOentswithgoodLDL-Ccontrolwassignificantlyhigherforphysicianswithhighempathysores(59%)thanphysicianswithlowscores(44%,P<.001).

•  M.Hojatetal,(2011),PhysiciansempathyandclinicaloutcomesfordiabeOcpaOents,ACADMEDMAR;86(3):359–64:doi:10.1097ACM.0b013e3182086fe1


MetaAnalysis

•  “[…]ThereisastaOsOcallysignificanteffectfortheinfluenceofthetherapeuOcrelaOonshiponhealthcareoutcomes[d=-.23to.66;combinedeffectsizewasd=.11(p=.02)

•  JohnM.Kelley,HelenRiessetal,TheInfluenceofthePaOent-ClinicianRelaOonshiponHealthcareOutcomes:ASystemaOcReviewandMeta-AnalysisofRandomizedControlledTrials,PLOSONE[PublicLibraryofScience],April2014,Vol.9,Issue4;


Empathyandthecommoncold?!

•  InthosewithperfectCARE[ConsultaOonandRelaOonalEmpathy]scores,coldduraOonswithshorter(mean7.10daysversus8.01days)[….]Inthesemodels,aperfectscorealsocorrelateswithalargerincreaseinIL-8[immunecytokine]levels(p=0.015)– DavidP.Rakeletal,(2009),”PracOOonerEmpathyandtheDuraOonofthecommonCold,FamMed41(7):494–501.


MoreTakeAwaysandSummary•  Thesecret,undergroundhistoryofempathytraversesHume’s“delicacyofsympathy”andKant’s“communicabilityoffeeling”

•  Empathyishardtoteach,butonewaytodosoisremovetheobstaclestoempathy–removetheobstaclesandempathyshowsup

•  Listeningtoone’slistening–thevoiceover•  ThemulO-dimensionaldefiniOonofempathy•  Disordersofempathy


a rumor of empathy: what empathy is and how it makes a ...€¦ · • compassion – altruism –...

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