Cultivating Empathy

Do We Really Know How Our Clients Feel?

Magazine Issue
July/August 2022
Cultivating Empathy

When I told my daughter, Jenna, that I disagree with Brené Brown’s take on empathy, she was horrified. “You’re saying Brené Brown is wrong?! She’s awesome!” A professor of social work, Brown hosts her own podcast, has a filmed lecture on Netflix, and is the author of five New York Times bestsellers. And her two TED Talks have, combined, been viewed upwards of 75 million times. As a devoted member of Team Brené, Jenna is obviously in good company.

Brown is indeed awesome. But despite her excellent research on shame, courage, and vulnerability, and despite her popularity in my family and around the world, some of her notions about empathy are off kilter. I approach the subject of empathy not as a researcher, but as a psychotherapist, supervisor, and family therapy professor with thirty years of experience.

Brown has popularized nursing scholar Theresa Wiseman’s recognition that empathy requires perspective taking, the avoidance of judgment, and the understanding and communication of another’s feelings. In her 2018 book, Dare to Lead, she wisely clarifies that empathy is a choice to connect. Her recommended ways of connecting with someone who’s suffering, though, are all inspired by her conception of empathy as an expression of shared feeling and analogous experience: “I get it, I feel with you, and I’ve been there”; “I know that feeling and it sucks”; “I’ve been in a similar place and it’s really hard”; “I understand what that’s like.” All these statements are claims of understanding that attempt to establish a relationship of equivalency or mutuality with the listener.

I remember seeing such a claim crash and burn when one of my doctoral students, Randall, was in a first session with a mother and her 11-year-old son, who were grappling with the recent death of the son’s father. I was watching from behind a one-way mirror with the rest of my team of supervisees as Randall told the family that he, too, had lost his father at a young age.

“My dad died of cancer when I was 12,” he said, “so I understand how painful this is.”

“No, you don’t!” said the son through tears. “Nobody understands.”

Taken aback, Randall patiently reassured him that No, he actually did understand, he really did.

“You don’t understand anything,” the son seethed.

The family didn’t return for a second session.

Randall was trying to make an empathic connection, but his claim about the equivalency of their respective losses produced the opposite effect. The son left feeling more, not less, alone. What went wrong?

People who are suffering often feel uniquely stricken, so if you inform someone that you “get” them, perhaps bolstering your assertion with a description of what you consider to be an analogous experience, don’t be surprised if they blow you off. And if you then have the temerity to argue your point, you may find that they, like Randall’s young client, find it necessary to put you in your place.

You’ll have better success if you approach clients with respectful humility. Rather than proclaiming that you understand them, you’re far better off initially assuming that you don’t have a clue what they’re going through. This positioning frees you up to pursue empathy not as a means of reassuring clients that you know their pain, but, rather, as a way of encountering them with open curiosity and a commitment to learn.

As you explore the details of your clients’ experience, you offer up for their scrutiny what you’re discovering about them. In the process, you demonstrate, rather than claim, what’s coming into focus, offering impressions rather than conclusions. You leave it up to your clients to determine whether your empathic appreciation of their world is accurate. They’re the ones to decide whether you’re “getting” them.

Finding Empathic Curiosity

In Daring to Lead, Brown says—I think correctly—that sympathy involves feeling bad for others (as in, “So sorry you’re hurting”). But she loses me when she goes on to define empathy as “feeling with people” (as in, “Hey, I know what it’s like down here, and you’re not alone”). If you look at the origin of the word sympathy, you’ll find that it means “feeling or suffering together.” This sense of the term is still alive in descriptions of the physics of sound. If you strike a tuning fork and hold it near another one, you’ll hear the result of the second one vibrating in sympathetic resonance with the first. So, in fact, it’s sympathy, not empathy, that involves feeling with people. We feel bad for them as a result of feeling with them.

What, then, is empathy? With its origins tracing to a Greek word meaning “feeling or suffering into,” it has to do with developing a felt sense of another’s experience through the exercise of your proactive imagination. In contrast to the receptive willingness of sympathy to resonate passively with the other’s emotion, empathy involves a projective curiosity, a desire to develop and communicate a visceral understanding of the other’s experience from inside their world. We empathize with other people as a means of developing a sense of what it must be like to be them—not to feel with or for them, but to get a feel for them.

Such an understanding of empathy alters your engagement with clients. You go in search of a body-informed, fleshed-out answer to the multifaceted orienting curiosity, If I were you in your situation, what would I be thinking, feeling, doing, wanting, hoping, demanding, protecting, remembering, anticipating? To empathize is to hallucinate yourself inside the other’s world, immersing in their experience and discovering what you learn from there.

Asymmetrical Availability

If you assert sympathetic resonance with another person—“I’m with you because I’ve been through something similar to your experience”—then your relationship with them will have a symmetrical quality, a feeling of equivalence or reciprocity. This often happens with friends and lovers, with whom closeness and trust are advanced via mutual sharing. Interpersonal intimacy develops sympathetic resonance when one person offers a revealing story or emotion and the other responds in kind. Both individuals can best nurture this growing bond by making space for what Brown appropriately celebrates as a dance of mutual vulnerability, allowing themselves to be meaningfully seen. But even in friendships and romantic partnerships, such intimacy is likelier to deepen if each person commits to curiously and cautiously probing and learning, not presumptively and confidently reassuring and claiming. This is where empathic curiosity comes in.

As therapists, our use of empathy is inherently asymmetrical. Intimacy in a clinical setting is advanced not through the symmetry of mutual sharing, but through the asymmetry of respectful exploring. As our clients reveal themselves in stories or disclose fears or yearnings, we don’t encourage further trust by offering revealing personal stories or by making disclosures of our own; rather, we communicate our steadfast commitment to them through our nonjudgmental acceptance and continued curiosity. We maintain a focus on their experience and their search for change. Our job is to fully show up and engage—to be available, not vulnerable.

Starting from a position of not knowing, or at least not yet knowing, how, what, or why our clients are suffering, we set out to gather a sense of their experience, and as we begin to get a feel for it, as it begins to come into focus, we need to demonstrate, not claim, what we’re coming to understand. We describe our impressions, not our conclusions. This leaves it up to our clients, not us, to determine whether we’re forming an accurate empathic appreciation of their world.

Floating Hunches

Of course, effective empathic communication is much easier to describe than to implement, especially when sitting across from someone in distress. Instead of attempting to reassure or convince them that you already understand them, you embark on learning about them, offering glimpses along the way of a developing but tentative sensibility, open to revision or nuance in response to their feedback. Gradually, a sense of what it must be like to be them comes into focus—a recreated version of the reality they’re relaying. We mention details they provide, and we float hunches about the emotional effects these details have been having on them.

As clients hear our descriptions and guesses, they recognize us more as insiders than outsiders. They learn to trust us. When impressions, ideas, and suggestions are communicated from this insider position, clients are less likely to view them as impositions to be guarded against than as invitations to be considered and accepted.

One of my clients, Camila, came to talk about how she was being shut down by her demanding and demeaning boss. Camila was born in the U.S. but had lived the first 10 years of her life in Venezuela, and throughout her life she’d struggled to liberate herself from her family’s belief that women should be deferential to men. Although slight and, at first glance, reserved, she possessed a subterranean spunkiness that showed up in the way she laughed and huffed when she described exasperation or indignation.

“I just couldn’t take my boss’s sarcasm anymore,” Camila told me at the beginning of one session, drawing herself up and narrowing her eyes. “I refused. I was scared to death, but for the first time, I stood up to him.”

“You were determined,” I said, inferring this from her steely tone.

I floated determined as a contribution alongside what Camila was saying. When communicated effectively, an empathic statement feels like a juxtaposition, not an imposition. In other words, what you say is juxtaposed with—placed next to—what they’re feeling and describing. If what you offer is in sync with their experience, they’ll let you know by agreeing with what you say or by using it as a steppingstone to a further exploration of what’s going on for them. By offering hunches rather than assertions, you protect clients from needing to defend their position, and you earn their trust, making it safer for them to be vulnerable as they share their heart and mind.

“Yes!” Camila said, confirming that my guess was in sync with her experience.

“Despite being frightened,” I replied. My response was an empathic rendering of what she’d said, but I should’ve said, “Despite being terrified.” My choice of words muted the intensity of her description.

Your clients’ emotional engagement with you gives you a feel for how they’re making sense of themselves as the protagonist of the story they’re telling. Camila had stood up not just to her boss, but to a family convention and to the embedded belief systems of a patriarchal culture and religion. She was vibrating with the magnitude of what she’d taken on.

“I was roiling inside,” Camila continued.

“Ready to blow?” I wondered. This hunch came from my imagining what I might’ve felt in her position. As it turned out, I was wrong.

“No. . . . I wasn’t so much angry. More fed up,” Camila said. Her correction helped me improve the resolution of what I imagined she was feeling.

“You’d had enough,” I said, in a louder, more clipped voice. In my tone and pace, I attempted to capture something of the emotional tenor of her fed-up determination. When accurate, the matching of paralinguistic cues and nonverbal behavior expands your empathic connections.

“Absolutely.”

“But with enough roiling in the mix to prepare you for what you needed to do.”

Camila laughed. “That’s for sure.”

From the wonder in her voice, I guessed that she was a little shocked at what she’d been able to do. Curious to explore this further, I used empathic statements to shift the focus from the nature of her involvement in her story to what was happening for her here, now, in my office as she was relaying it.

“Which even now seems a little surprising,” I said, capturing with my tone something of her incredulity.

“Yeah, I still can’t quite believe it,” Camila replied, laughing.

“A discovery.”

“Oh, I’m pretty pumped. I finally did it.”

I vividly remember two occasions in my 20s when I was being treated disrespectfully by an authority figure. Miserable and confused, I felt cornered, helpless, shut down. And I remember that I, too, accessed an ability to say No! Those were life-changing moments, but for numerous reasons our situations weren’t analogous, and it wouldn’t have helped Camila to hear about mine.

If, as you’re listening to a client’s plight—or, as in the case of Camila, their triumph—a memory surfaces of something you went through that seems comparable, turn toward it and use it as a storehouse of potentially useful information about what it may have been like for your client at the time, or what it might be like for them now. Rather than claiming insider special knowledge—“I know just what that’s like, and, man, it’s tough”—earn insider status by venturing unreferenced, personally informed hunches of what you imagine their experience to be. And when you’re wrong, drop what you thought you understood and adjust your sense-making and comments accordingly.

I used my own memories to float another hunch to Camila: “Now you realize you’re capable of it and can feel—I don’t know—rightfully proud? But when you stood up to him, you were discovering that potential in the moment. I imagine it was a kind of revelation.”

“Right. I didn’t know I was going to do it till I was doing it,” Camila said.

This conversation was the first time Camila had allowed herself to fully reflect on and realize that what she’d done was an act of freedom, rather than disrespect. She’d long assumed that the overwhelming difficulty she’d felt in standing up to her boss was the result of a character defect: too shy, too anxious, not enough self-esteem. But as we talked further, what came into focus was the degree to which she’d been in the thrall of powerful and implicit cultural messages. By keeping my attention on Camila’s experience, not my own, and floating only tentative hunches, I was able to demonstrate, not claim, empathic understanding—and that opened the door for her to explore what the experience meant to her.

Empathic Connection

If Randall, my supervisee, had put into practice what I’ve been suggesting here, his interaction with his young, bereaved client would probably have gotten off to a very different start. When he learned that the boy’s father had recently died, he could’ve drawn on his memory of losing his own father to help him float tentative thoughts and informed questions, starting, perhaps, with something like this: “That’s so much to have to deal with at your age. How are you even getting through your days? I bet it’s hard to pay attention to anything going on in school.”

The boy wouldn’t have had to defend the uniqueness of his loss; he could’ve taken in Randall’s statement and responded with his own experience: “I only just went back, but I don’t want to go. My mom’s making me.”

Remembering his own struggles, Randall would’ve then been well positioned to offer a well-tuned hunch. “Of course, you don’t—probably feeling pretty empty inside.”

And now the boy’s tears would’ve been not in defiance of someone presuming and intruding, but in response to a description that resonated with and normalized his world.

Watching the boy’s body, his breathing, his face, the way he was relating to his mother, who also may have been crying at this point, Randall could’ve cautiously continued, ready to alter course if the boy’s body language suggested that Randall’s intonation or phrasing was off: “And I’m guessing that nothing much seems to help, especially not the adults who urge you to be strong for your mother or who tell you that it’s going to get better. Nobody knows how hard it is to breathe sometimes, how heavy it can feel, how lonely. And, of course, you’re worried about your mother, but, jeez, to have that put on you, on top of your dad dying? How much can a guy take?”

No claims. No striving for mutuality. No reassurances. Just unadulterated empathic connection. When the boy didn’t have to keep Randall at bay, he’d likely have been able to accept the possibility that this adult was different and had something to offer.

Given his own history, Randall might’ve had to take extra care to maintain his professional boundaries, ensuring that the intimacy he established was asymmetrical (grounded in curiosity and availability), rather than symmetrical (oriented toward mutual vulnerability). Such boundaries protect an integral sense of self in the midst of empathic explorations.

It helps that empathic curiosity is not a feeling that comes over you, but, instead, as Brené Brown makes clear, a choice to engage, a purposeful approach to relating to and delving into client experience. This means that just as you choose to enter into your clients’ reality, to make yourself available to them, you can choose to exit it, to come back into your own, distinct sense of self. You can practice what I call empathic enclosure. All you need is a means and method for collecting yourself, for leaving behind this hour’s client and getting centered before starting your next appointment.

Working empathically decenters you in the therapeutic process. You use your personal history and your body-based sensibility to help you maintain your focus on, and make visceral sense of, your clients’ experience. And when it comes time to explore solutions to their conundrums, you, situated as an insider, won’t feel the need to reach for the latest intervention or to dispense expert advice. Rather, through your empathic connection, you’ll have discovered resources of which your client may not even have been aware, and you’ll be well positioned to co-invent possibilities with them from inside the logic and richness of their world.

A commitment to empathy is a commitment to asymmetrical availability and professional intimacy, making possible collaborative discovery and change.

 

Illustration @ Illustration Source/James Endicott

Douglas Flemons

Douglas Flemons, PhD, LMFT, lives and maintains a telehealth practice in Asheville, North Carolina. Professor Emeritus of Family Therapy at Nova Southeastern University, he’s coauthor of Relational Suicide Assessment, coeditor of Quickies: The Handbook of Brief Sex Therapy, and author, most recently, of The Heart and Mind of Hypnotherapy.