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Empathy: How it Helps and How it Hurts

by Rev. Stephen Dietrich, BCC

APC Forum, September 2018, Vol. 20 No. 6
 

The purpose of this paper is to explore the power of story-telling, to demonstrate how empathy can help and how it can hurt a chaplain’s effectiveness, to uncover some of the ways we fail to understand those in our care, and to suggest how professional chaplains can address these issues. 
 
Empathy can be transformative
 
The inspiration for this paper came from an online article in the New York Magazine called, “Can a Gun Victim and a Gun Advocate Change Each Other’s Mind?” (Miller, 2016).  The author begins the story with introductions:  He, Todd Underwood (a gun merchant), auctioned off the pistol that killed Trayvon Martin.  She, Carolyn Tuft, watched her child die in a mass shooting.  “Can they change each other’s minds about guns?” 
 
The author also introduces Narrative 4, whose mission is to build empathy among a group of people through storytelling (https://narrative4.com/).  Each member in a group is paired with someone who holds the opposite position on an issue, and each person tells their story to the other. Then the larger group comes together, and each person takes a turn telling a story – not their own story, but the one that they just heard from their partner.  Importantly, each person is asked to tell the story in the first-person as if it were their own. 
 
In the article, Tuft and Underwood were paired together, and the issue was gun control.   There were two remarkable transformations using the Narrative 4 process.  The first happened during the second day, when they shared each other’s story with the larger group.  Miller wrote, “Nothing else that happened that weekend begins to compare to those 13 minutes, when Carolyn Tuft and Todd Underwood took possession of one another’s stories. Other storytellers were sensitive, respectful, perceptive, and earnest — but none started out so far apart, ideologically, so none was challenged, in quite the same way, to reach for the same level of empathic generosity… Todd and Carolyn proved that radical empathy is at least possible. They were shape-shifters. They became each other… The organizers, who have seen versions of this a hundred times before, were crying. No one in the room that day will ever forget what they saw”.
 
The second transformation happened a week after this event, when Miller and Underwood spoke on the phone.  Did the experiment work?  Underwood is still a gun enthusiast, but now he knows how it feels to be the victim in a mass shooting.  While on the phone, he confirmed that he is still a gun rights advocate, but he was making some policy changes to his online gun business that would make it harder for felons to buy his guns.  A transformation had occurred.
 
Empathy can be biased and narrow
 
Paul Bloom, a psychologist at Yale, affirms that empathy has a necessary and real social value.  He states, “… empathy serves to dissolve the boundaries between one person and another; it is a force against selfishness and indifference” (Bloom, 2014).  However, Bloom also has concerns, “… Empathy is biased; we are more prone to feel empathy for attractive people and for those who look like us or share our ethnic or national background... And empathy is narrow; it connects us to particular individuals, real or imagined, but is insensitive to numerical differences and statistical data.”  Bloom argues that this quality of empathy explains how people can fixate on news of a little boy trapped in the bottom of a mine shaft but struggle to care about issues like climate change.
 
Bloom also distinguishes between emotional and cognitive empathy, or “heart and head” empathy.  To emotionally empathize is to feel with a person – to have all of the same feelings (or at least, what we imagine another person is feeling).  Cognitive empathy is about perspective taking – grasping a person’s situation or “walking in their shoes”.
 
Marianne LaFrance (2014) responds to Bloom’s argument by suggesting that using a combination of emotional and cognitive empathy avoids some of the hazards of relying only on emotional empathy. Using “attribution bias” research she suggests that when we speculate about the reasons for someone else’s actions, we tend to attribute their actions to internal forces.  However, when we reflect on the reasons for our own actions, we usually attribute them to external forces.  For example, if I see someone working overtime, I may think that they’re a workaholic or have a manic personality.  However, if I work overtime, I am more likely to believe it’s because of a demanding boss or an extra heavy workload.  If we want to correct our attribution biases, in addition to exploring someone’s potential internal influences, we should assess their external influences or circumstances so that we can better understand someone’s entire story (LaFrance, 2014).  
 
The physiology of empathy
 
Emotional empathy may be biased and narrow, but prolonged states of emotional empathy can also be bad for one’s health (Bloom, 2014).   Emotional empathy comes with a cost, possibly leading to anxiety, depression, burnout, and even empathetic distress, characterized by the inability to tolerate the perceived pain or suffering of another.  
 
To understand how a person experiences pain in their brain, neuroscientists use functional magnetic resonance imaging(fMRI) to measure brain activity by detecting changes in its blood flow.  This imaging enables neuroscientists to see what parts of the brain are being activated in real time when someone is experiencing pain as well as pleasurable experiences, like eating chocolate. 
 
Singer (2013) investigated the neuronal basis for empathy by using fMRI to visualize where brain activation happens when someone experiences physical pain and when someone only observes another person experiencing physical pain.  Interestingly, the places in the brain that were activated when someone was experiencing physical pain and when someone was only observing another person in pain were the same. 
 
Is there a way to affect how the brain processes empathy?  Singer worked with Matthieu Ricard, a French writer, molecular geneticist, and Buddhist monk, to investigate this using fMRI.  Ricard immersed himself in different states of empathy, transitioning from thinking about the suffering of someone he knew well to thinking about the suffering of people he did not know personally.  All of these states looked similar and activated the same region of the brain.  However, one particular state did not look like the others.  Singer was so struck by this that she interrupted Ricard while they were in the middle of the experiment and asked, “What are you doing?  It doesn’t look at all like what we usually observe when people feel empathy for someone else’s suffering.”   The fMRI display showed that Ricard had activated a different area in the brain – one usually associated with looking at babies, a lover, or eating chocolate.  Ricard responded that he was practicing meditation, specifically “Metta” or “compassion meditation”(Ricard, 2015).
 
This Buddhist form of meditation was modified so that it could be easily taught to others and termed “Compassion Cultivation Training” or CCT (Klimecki, 2013).  In the simplest of terms, CCT begins by inviting an individual to take some time to remember a person in their life whom they associate with love, warmth, and other rewards.  Next, they are invited to imagine offering these same positive feelings to a family member or a close friend.  Finally, they are asked to imagine offering these feelings to an acquaintance or even a stranger (Klimecki, 2014). 
 
In an experiment to evaluate the effect of CCT on empathy responses in the brain as measured by fMRI, Klimecki et al. (2014) compared individuals who had received CCT training with those who had not just prior to watching 10-18 seconds of video scenes depicting distressed people.  All of the negative feeling and empathy ratings between the two groups were the same; however, remarkably, individuals who’d received CCT also demonstrated increased levels of positive feelings as well.  These measurements demonstrated that by remembering the love and warmth we experienced from others in the past, we can increase the positive feelings we have for others experiencing distress in the present. 
 
Chaplains’ empathy
 
Chaplains are professional storytellers.  We use our patient’s story to explain our interventions and contribute to their care plans.  We tell their story in insightful and compelling ways as we advocate for their care.  Our stories are powerful tools. But there can be costs to being good listeners and storytellers, especially if the stories hold pain and suffering.
 
As we strive to understand another’s pain, we delve into our own personal memories of pain, which can eventually lead to empathetic distress and burnout.  Research suggests that we can consciously access our own positive memories to mitigate empathetic distress.  Accessing memories of our experiences of receiving compassion from others, of being cared for and appreciated, can help us provide these same feelings of compassion to individuals in our care.
 
A chaplain’s empathetic skills are vital, but biases can undermine our capacity to effectively empathize.  The Chaplain’s first professional identity competency states, “Be self-reflective, including identifying one’s … limitations.”  We need to pay attention to our aversions and our attractions in order to discover our limitations (such as our biases) and then effectively address them. 
 
Emotional empathic assessments of our patients are not enough.  A chaplain needs to evaluate both a person’s feelings (internal forces) and their situation (external forces) to create an effective and holistic assessment. 
 
 
References:
 
Miller, L. 2016.  “Can a Gun Victim and a Gun Advocate Chang Each Other’s Mind?” New York Magazine, 26 December.  http://nymag.com/daily/intelligencer/2016/12/gun-violence-radical-empathy.html.
 
Bloom, P.  2014.  “Forum, Against Empathy” Boston Review, 10 September.
http://bostonreview.net/forum/paul-bloom-against-empathy.
 
LaFrance, M. 2014.  “Forum Response, Against Empathy,” Boston Review, 26 August. http://bostonreview.net/forum/against-empathy/marianne-lafrance-response-against-empathy-lafrance.
 
Klimecki, O., Ricard, M., and Singer, T.  2013.  “Chapter 15, Empathy Versus Compassion, Part 3, Science of Compassion,” in Compassion Bridging Practice and Science, Eds. Singer, Tania and Bolz, Matthias.  Munich: Max Plank Society.  www.compassion-training.org.
 
Ricard, M. 2015. “From Empathy to Compassion in a Neuroscience Laboratory.”  Altruism: The Power of Compassion to Change Yourself and the World.  Little, Brown and Company.  http://www.matthieuricard.org/en/articles/from-empathy-to-compassion-in-a-neuroscience-laboratory.
 
Klimecki, O., Leiberg, S., Ricard, M., and Singer, T. 2014. “Differential pattern of functional brain plasticity after compassion and empathy training,” Social Cognitive and Affective Neuroscience9(6):873-879.  https://doi.org/10.1093/scan/nst060.


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