Empathy by Nicholas Barton

Empathy is the single most important attribute of a therapist. His ability to put himself in his patient's shoes, to feel along with the patient, to appreciate at a "gut level" what the patient is experiencing is of far greater value than any learned skills. He can more than get by on it when his learning lets him down, which it inevitably will at some point.

Empathy builds that all important sanctuary of trust. It tells the patient without any sales pitch having to be made that the therapist is on his side, serving his interests and, although he is not experiencing exactly what the patient is going through, he understands it as far as he is able in a complete way. It is much easier to open up to someone if he understands the language you are using and the language of feelings, needs and pain is no exception.

Empathy not only conveys the support but also creates the impression of having someone on one's own level and not someone standing over one with the short-sighted condescension of pretentious authority. The empathic therapist responds from true feelings. He uses the truth of his feeling to help the patient uncover his own as yet unfelt truths.

Clever students of therapeutic technique can learn to simulate empathy, and quite convincingly, but because it is always counterfeit it lacks the easing power of an honestly felt appreciation of the patient's experience. Most patients can detect the difference. It is certainly not as effective. A therapist who knows what his patient means because he knows the meaning of his own feelings can get through at a level that the pure technician cannot. The technician may rely too much on words, and though they may be the right words they may come at the wrong time or be said in a way that is devoid of true feeling. The empathic therapist knows his proper feeling for the patient is conveyed not in words alone, just as feelings themselves are not; it is in the very presence of a person. Empathy is demonstrated in listening, which is a passive occupation. One can learn to listen to a degree, one can be trained to look out for certain signals, but even the most advanced training will not be able to cover all the ground. The ability to listen comes from having a mind not deafened with one's own fractured pain not cluttered with needs impatient for the opportunity to project. The patient is confident when he feels that his therapist is not distracted by some agenda of his own and is not off somewhere else attending to it - possibly through him.

As Anthony Storr wrote in his succinct book, The Art of Psychotherapy, true empathy manages to remain objective. Empathy without objectivity is as little use as objectivity without empathy," wrote Storr. "The therapist has to walk a tight-rope between over and under identification with his patient. If he so over-identifies with him as to lose his power to criticize, he will not be able to see how the patient should change. If he remains as detached as if he were performing a scientific experiment, he will not be able to understand his patient as a person or appreciate the difficulties that he faces. It is because of this that the practice of psychotherapy will always remain more of an art than a science." Thus the therapist maintains his parallel relationship to the patient rather then merging with him. When he has unconscious primal motives the therapist may over-identify and thus collaborate in prolonging neurotic defenses. In this situation the therapist has allowed himself to become part patient. He may influence the patient to avoid or even to deal with problems that are more the therapist own. It may seem like a delicate balancing act, as Storr suggests, but it becomes much less so the more the therapist deals with the hidden influences from his own unconscious. It is this that frees him to have genuine empathy and true objectivity. With fewer and fewer primal needs to cater to or to pacify and with fewer hurts to defend against, he can play his part as an authentically free agent. Walking tight-ropes comes from not being able to trust one's feelings fully, knowing as we do that there are dark pitfalls waiting for one to slip into. The more open the therapist becomes, the more he knows he can trust his intuition and this sense of confidence is conveyed to the patient, who in turn begins to trust the therapist and himself more freely and more deeply.

The objectivity of empathy arrived at through feeling allows a therapist to help people he may not initially like. It usually helps him find the likable qualities that everyone has somewhere within. Many neuroses have objectionable faces at first and someone without the objectivity of empathy may be blinded to the wounds behind the off-putting defenses. His own inner clarity will enable the therapist to see through t the real hurt self, which in turn will give the patient the feeling that it is finally safe to reveal himself.

This is not an argument against training the intellect for the practice of psychotherapy. Some things have to be learned. Empathy, however, is founded upon experience and not on the collection and digestion of data. You cannot teach someone to feel. It is not a craft or a skill. You can teach someone to apply what he feels and to understand what those feelings mean in the context of therapy. The long and the short of it is to empathize you need to feel and the more deeply you feel the more scope your natural capacity for empathy will have.