Week 1: Empathy

“The great gift of human beings is that we have the power of empathy.”
Meryl Streep, actress

Is it even possible to find a more complex and misunderstood word? A word that bridges the gap between human experience, reactive emotion, compassionate thought and altruistic connection.

The idea of empathy was first described in the 1880’s by a German psychologist Theodore Lipps, who coined the term “einfuhlung” (literally, “in-feeling/touch”).  For me, this definition of empathy best encompasses the full meaning of the word in neutral context: The process of appreciating and understanding a person’s subjective experience while maintaining some degree of professional or personal distance.

As a physiotherapist or health care provider, having empathy is to be concerned with a much higher order of human relationship and understanding of your patients. For me, empathy has been a crucial and required altruistic communication skill as I am faced on a daily basis with overwhelmed and anxious new moms with their newborns, and scared, devastated and at times unrealistic expecting parents of babies and kids with special needs or medical respiratory problems. Our patients expect a lot from us and trust us with their vulnerability. We have to be careful of becoming too emotionally involved or invested in our patients’ lives and human experiences, as you can loose your professional objectivity and blur the patient-therapist boundaries. It can also lead to emotional burn-out by making you feel like you are responsible for your patients’ happiness and solving all their problems. I am of opinion that maintaining a healthy, altruistic but professional relationship with all your patients is key.  By being honest with sensitivity and compassion, listening and observing with all your senses and just taking the extra time to let your patients or their families speak or ask questions, really help to build a trusting patient-therapist relationship and human connection without sacrificing your professional objectivity.  Having mild empathy enhances every facet of holistic management and patient outcomes.

In this fast-paced world driven by quantity rather than quality, it often happens that we forget the importance of human compassion and understanding.  We have all heard or know of health care professionals with “poor bedside manners”. They often speak using medical jargon, talk down to patients or their loved ones, don’t make eye contact, rush through each consult or therapy session, brush off or interrupt patients asking questions, raising their concerns or discussing aspects of their lives.  Many health care professionals consciously choose not to interact with their patients on an emotional level, as they don’t see the point or are unsure of how to deal with it as vulnerability means uncertainty and they only want to focus on objectivity and what they can control. There is a fine line between empathy with professional distance, and sympathy with personal involvement.  I believe as human beings and more important as health care professionals, we have the ability and responsibility to expand our perceptions, lean into the discomfort of vulnerability and spend a little more time focusing on others in need by treating them with common decency and respect.  Remember, you cannot treat others with compassion if you are not kind to yourself first.

Now the controversy… Can empathy be taught? Some may argue that empathetic engagement in patient care or society can be taught… Some believe that it can be enhanced by various emotional intellect and communication skills training programmes and experiences. Others are of the opinion that empathy comes from altruistic human nature, that it is an inherent emotional communication skill that elicits compassion and sensitivity, as all humans long for connection… But it is still a choice, to engage or not to engage….  Where do you stand?

I’ll leave you with Alanis Morissette:

“…Thank you for seeing me, I feel so less lonely.

Thank you for getting me. I’m healed by your empathy…”

Blog Post: Week 1, themed “Empathy”, for PHT402 Online Professional Ethics Course

19 responses »

  1. Hey Chantelle! I completely agree with everything you have written haha. Balance is the key not to success but to everything. Every aspect of life requires a balance to function and this especially applies to the field of healthcare. As you said, some healthcare professionals need lean into that discomfort zone and BE vulnerable/uncertain because only then can they start to fully appreciate what’s going on with their patients.

    I believe this quote can relate to vulnerability in general. If it makes sense… embrace it. The support comes after – never before.

    “There is no less invention in aptly applying a thought found in a book, than in being the first author of the thought.”
    -Pierre Bayle

    • Hi Jackie. Thank you for reading my post. Yes, I agree, “living a balanced life”. I’ve seen it so many times, especially in a large physio practice I worked at just after qualifying. It’s easy to get side tracked about what is important, and with the focus being on you and what you accomplish instead of the patient, is where things go wrong. Having success-driven thoughts such as how many patients did I see (I can do so much in so little time, I work so hard), how many diagnoses did I make (I’m so clever) and how much money did I make (it’s all about the money) is often times why empathy is pushed aside as it’s not about you.
      So I am grateful for this first week’s topic of “Empathy” to remind us of it’s importance.

  2. Brilliant, post. Love the controversy and would ask where you stand. I would unfortunately be somewhere in the middle as have known people who’s requirement to develop some semblance of empathy was taught, though it could be argued they only learnt to listen and communicate and others that have had a naturally ability to understand others, whether nurtured into them or just part of their nature I would not be able to tell, though it could be argued they have natural cross over skills and not necessarily empathy as the definition/understanding of the definition varies.

    • I agree, I’m somewhere in the middle too! I think it’s a natural altruistic skill that needs development and can be enhanced, but some people just don’t have that capacity. Thoughts are so powerful, so it’s about what you think is important and worthy of your time and effort. It’s all about making a mind and heart shift to care about others, without judgement and selfishness. Thanks for reading my post 🙂

  3. I like your post. It is true that sometimes we get carried away with other things like seeing many patients in a day forgetting what really matters; the quality of care that we bestow on our patients. Regarding this week’s topic I truly believe anyone can learn to be empathetic. If this saying that some leaders are born while others are made is true, then it is also true that other people were born kind,down to earth and so caring while others are born rough and impatient naturally and need to learn to be empathetic, so this comes to the matter of choice.

    • Hi Emma, thanks! I agree with you. Personality plays a part, as well as your emotional intellect and ability to recognize the effect your actions and words have on others around you. There will always be people that choose to live an egocentric life and really don’t care about others. Being empathetic is just as much a choice as it is a communication skill.

  4. Interesting blog, but I am interested in what happens to ones treatment quality when treating a patient that you are not emotionally connected to (whether through empathy / sympathy or pity ). Because you show no form of emotional connection does that mean you treatment is second-best.

    does empathy make your treatment better than it would have been?

    I think if one is able to still able to provide the best physiotherapy treatments without involving any emotions, then maybe there is no room for emotions in treatment rooms. Because it would be problematic if we give good treatment healthcare to patients that we are only emotionally connected to only.

    • Hi Cecil, I understand what you are saying and respect your opinion. I am of the opinion that what you are describing is a one dimensional approach to health care, a very outcome driven approach, where a patient is just a patient with a problem you can try and fix. You only see the clinical problem, you diagnose after physical assessment and history about the problem, (all very isolated and out of context), apply your selected clinical treatment and focus on getting a good outcome, albeit short lived. The focus is on you as therapist and your success and performance, but it should be about the patient, context specific and comprehensive/holistic. I am sure good and effective treatments speak for themselves, but the majority of the time, our patients, who are human beings with thoughts, opinions, beliefs and emotions, have complex problems and if you choose not to engage with your patients with compassion and understanding, you are treating them out of context with no regard for the impact their lives or emotions are having on this “problem”.

      I work in some of the sensitive fields in physiotherapy. Especially in the field of special needs babies and children. I need to be sensitive and compassionate as it is a life changing journey for these parents who are trying to cope and just deal with all of it. I need to build a trusting relationship with professional boundaries with the parents of a child with special needs, as well as a trusting relationship with the little one (this aunty helps me, it’s fun, and doesn’t hurt me, so I enjoy it!), in order for them to trust me with their child, to feel comfortable to tell me their concerns in order for me to help them to the best of my ability, to start helping them engage in providing the environment for their little one to reach his full potential. Often times if you just treat the child, give a home programme and expect the mom to carry on with it, it doesn’t work… Why, because you haven’t seen this child, central to his family, in a holistic context. What can they cope with? What concerns do they have? Can they afford weekly therapy? How can I make this programme better suited to their lifestyle and needs? What happened this week that is making it hard for them to be present in the sessions? Do they need other support services? Taking all of this into consideration will improve your therapy approach and holistic management. And I believe your patient will then benefit the most. That is what it is all about. You cannot isolate and just treat out of context. Especially when working with kids!

      I will give you an example:
      I saw a 10 month old little boy with Down Syndrome at home for therapy twice a week for a few months. Mom wasn’t told anything about the syndrome and didn’t know what to do or what to expect. She was afraid to do the exercises with him and had no support system, she felt lost, alone and vulnerable. So I couldn’t just force a programme on her and expect her to cope. So we had to take things very slow and teach her simple things that she felt comfortable with trying. He was doing so well, sitting by 8 months and starting to wiggle and pivot on his tummy, when he got flu and after getting a severe rash I referred her to a paediatrician for blood tests etc. She just called me after all the tests and said “He has leukemia Chantelle, the doctor just phoned and told me. Just like that. It’s all over. What now?!”. Can you believe a physician would break the news of cancer over the phone… now that’s the complete opposite of empathetic engagement. How can any human being not feel compassion and shock? How can any physiotherapist just say “well, it’s not my problem, it’s not within my scope of practice and I don’t care how you feel as it won’t change anything… so I don’t want to talk about it, phone your doctor for treatment options”. Just imagine taking your 10 month old baby for chemo the first time? Now my role has changed and we have to change his therapy programme and goals… It’s part of being a good therapist, caring and supporting your patients.

      When you work with illness, disability, pain and death, you need to have a heart and see and treat each patient and their family members as human beings.

  5. Having read a few blogs, the movie “Avatar” came to mind and I think that it is quite relevant to us dicussing empathy, human connection, compassion and “leaning into the discomfort of vulnerability and feeling”. The saying or greeting, “Oel ngati kameie” in the Na’vi language means “I see you”, meaning I see into you, I see your soul, I understand and respect you, we are connected. “To see” is to open the mind and heart to others and embrace connection. That’s what life is all about, the connections we make and finding our balance.

  6. Hi miss berg, it’s really nice to read your blog… Everything you wrote … Which describe your experience as well… Many things you wrote are absolutely correct and patients and peers both are expecting a lot from us in limited time … Here if physiotherapist empathise ( professional distance) with patients… They will never get your answers or attitude … On the other hand patients feel little un trustworthy on physiotherapist..”. Balance is the key” is the best thing you wrote in your blog and I like it… Thanks for the key 🙂

  7. Hi Chantelle, great words, really enjoyed reading your post and learning from your experience. As a mother I know how hard is the field you have chosen. Every mother wants her child to be perfect, wants the best care for her child and so on. About your question, I believe empathy could be taught if the person wants to be taught. I think there is a “scale” of empathy and every human is somewhere over this scale. The way I see it, its like flexibility, there are people who are more flexible while others are less but practice can lead us to our maximum ability. looking forward for your next post.

    • Hi Noam. Thanks for taking the time to read my blog post and comment, much appreciate your input. I agree with you, enhancing/nurturing empathy seems to be possible and it seems to be up to choice. I like your term “scale of empathy”, comparing it to flexibility. Makes a lot of sense. Thanks!

  8. Hello Chantelle,
    I really enjoyed reading your post, and it provoked me to do some self-analysis – always a sign of a stimulating discussion!
    I think your statement “There is a fine line between empathy with professional distance, and sympathy with personal involvement” is particularly relevant to the therapeutic alliance.
    And like you, I instinctively believe that each individual has a choice to engage or not to engage…

  9. I really enjoyed reading this post and I feel that you have really captured the idea of the assignment by sharing a personal experience. I think that you hit the nail on the head when you state that just by putting our whole self into each interaction we can create an empathetic connection with our patients. It does not always mean we need to take on every patients problems but it allows us and them to make a genuine connection surrounding the issue they may be facing. Thanks for the viewpoint!

  10. Chantelle 🙂 I really enjoyed reading your post. Very interesting indeed. The part that gets me most is where you spoke about being too empathetic which can lead to emotional burn-out. It’s important to get that balance of being mildly empathetic in order to avoid this. Sometimes it’s hard to get this right through my experience, as our human connection can over power us especially in a field we naturally love (paeds) lol. However, if it leads you to being the best professional you can be I’m sure it isn’t that much of a problem?

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