This article is part of our series on understanding others’ feelings. In it we examine empathy, including what it is, whether our doctors need more of it, and when too much may not be a good thing.
“I just get so angry when he says he will call and then doesn’t,” says Ellen about her boyfriend.
Her empathic friend might respond: “Yes, I can see how that would make you angry. I’m guessing underneath that you feel hurt.”
Whether Ellen agrees or disagrees, important communication occurs. She might learn something useful about her emotions, and the friend might learn something about Ellen.
Empathy is an interpersonal skill that can be viewed as part of emotional intelligence. Psychotherapist Carl Rogers wrote that empathy could enhance relationships and recommended it for ordinary people and therapists.
Studies support its value. Health professionals who show high levels of empathy tend to get better adherence to treatment from their patients and better patient outcomes. And beyond health care, empathy is associated with better personal relationships and more successful social behaviour.
In its most complete form, empathy involves understanding the emotion of another person, feeling the emotion and responding appropriately to it.
These three aspects of empathy constitute empathic cognition, emotions and behaviour.
Some people are good at understanding the emotions of others but not at feeling them or commenting on them. So can we teach people the parts they lack?
Naturally learning empathy
People who have an antisocial or narcissistic personality tend to have empathy impairments. So do those with autism or schizophrenia. There are also many children and some adults without a mental diagnosis who are low on empathy.
Some people are genetically inclined to be highly empathic or not. But, generally, we develop empathy as children, primarily through observing how others show it.
We may be on the receiving end of expressions of empathy and come to value it for the emotional benefits it had for us. Then we may show empathy ourselves and receive a positive response, such as praise or a smile, that reinforces our actions.
Some children are more fortunate than others with the number of episodes of empathy they observe and responses they receive for showing it.
To actively teach children empathy, parents can explain their own emotions during significant events. They can also discuss the emotions of the child as well as those of others. They can point out the connection between events and emotions.
For instance: “When I learned Poppy had cancer, I felt stunned at first, then scared and sad.”
Parents can model empathy by showing it when the child has a strong emotion, whether fear, surprise or something else.
They can prompt empathy by asking the child questions like, “How do you think your brother felt when you threw his toy and it broke?” They can also praise the child for showing empathy.
So can we teach it to adults?
Many parents, health-care professionals, teachers, work supervisors and romantic partners would likely benefit from higher levels of empathy. As would anyone low in empathy for whatever reason.
Researchers have examined whether it is possible to increase cognitive, emotional and behavioural empathy through formal training. The methods used to teach someone to be more empathic are in many ways similar to those used to teach a new dance or how to give a good public speech.
Training typically includes four elements. The first part usually involves instruction about the benefits of showing empathy, how to identify emotions in others, how to feel those emotions and how to comment appropriately on them.
Next comes providing models of a person showing empathy in response to something another has said or done. The models can be live, on video or audio, or written. The situation optimally includes a positive response to the appropriate expression of empathy. The model might sometimes fail to show empathy and subsequently demonstrate a better response.
The third step is practice at showing empathy. This might occur live with the trainer or online in response to written or audio comments or actions of another person. The practice would include, when possible, showing empathy in real situations outside training sessions.
The last step involves constructive feedback on attempts to show empathy. The feedback typically includes praise when the person has reacted appropriately. It might also include information about how better to assess the emotion of another person or respond to the emotion.
Does teaching empathy work?
A student and I recently completed a meta-analysis that pulled together 18 studies on the effects of empathy training. Our results indicated formal training can increase empathy.
The studies measured empathy in various ways, but many used test measures. These present situations and then ask: what would you say to the person?
Some studies asked for self-reports of empathy in everyday life. A few sought patient ratings of a professional’s level of empathy during patient-professional consultations. No matter which measure was used, the training tended to have a positive effect.
The findings of the studies we surveyed had limitations, though. The trainees who showed significant improvements were mainly health professionals or university students. And studies usually followed participants for periods of a few weeks at most.
So we do not know for sure whether we can increase empathy in ordinary people through formal training. We also do not know whether it is possible to help anyone make a long-term gain in empathy.
Some people might be challenging to teach, either because they lack motivation to increase empathy or because they find it difficult to imagine how others feel. Sex offenders, for instance, could be hard to help, as could autistic individuals.
Can we teach ourselves?
Adults can increase their empathy outside formal training. They can start by looking for signs others are experiencing an emotion. These can include facial expressions, postures, sighs, tone of voice, the content of what they say and their apparent situation.
If we imagine ourselves in the situation of another person, we take an additional step down the path of empathy. If we develop a hypothesis about the person’s emotion and gently present that to the other person, we may get valuable feedback and complete a self-instruction experience in empathy enhancement.
Of course, not everyone stands to gain from increasing empathy. Those in occupations that require dealing in an assertive or harsh manner with others might not benefit professionally. Consider the pressures on combat soldiers and police officers.
But for most people increasing empathy would have positive effects. Life provides opportunities for enhancing our own empathy. We just need to look for them.
Read the rest of our articles on empathy here.