Tuesday, October 20, 2020

Sympathy vs. Empathy

Today's post was written by my current attending, Steven Berger, MD. He wrote it for the residents to discuss. Something to ponder. (Goodness I am blessed to work with such wonderful compassionate attendings!)

Sympathy vs Empathy

Sympathy means similar. It consists of being similar to another person. For example, at a funeral, you express sympathy and say things such as: "You must feel awful," "I’m sorry for your loss," or "I can’t imagine what it’s like for you to lose a child." In a funeral setting, you are saying that you are supportive of the person in his sadness and that you stand beside him in his time of need. A friend feels and expresses sympathy.

Empathy means same. It consists of having the same feelings as the other person and being one with the other person. As a psychiatrist, you are the authority of thoughts and feelings. With the patient, you identify the thoughts and feelings the patient is having. You bestow credibility and acceptability to the person’s thoughts and feeling. You endure those thoughts and feelings with the patient. You become one (same) with the patient in his thoughts and feelings. Instead of saying sympathetic things, you say empathic things, for example: "You feel awful," "The loss of your child is unfair," or "I know you feel unconsolably grieved. I will endure that inconsolable grief with you."

In being sympathetic, you act as a friend standing beside the person. In being empathic, you act as a holy spirit co-existing with the patient in his experiencing his thoughts and feelings. You experience the patient’s thoughts and feelings with him. You demonstrate to him that he is not alone, that you are with him, that you are bearing his burden with him, you are on his side to deal against his struggles with him. You are more than just a team with him. You are one with him.

As a psychiatrist, you side with the patient against whatever devils he is fighting. Instead of opposing the patient by saying, “Those voices you hear are not real”, you side with the patient by saying, “How are you and I (together) going to deal with those voices?”

Personally, one of my favorite pieces on the difference between empathy and sympathy is a short, two minute cartoon by Dr. Brene' Brown. I first saw it during medical school orientation at Wake Forest. The images from this short clip have stayed with me since. It's definitely worth watching (click HERE to view), but in a nutshell Dr. Brown proposes that empathy consists of four key steps:

1. Perspective Taking, or putting yourself in someone else's shoes.

2. Staying out of judgement and listening.

3. Recognizing emotion in another person that you have maybe felt before.

4. Communicating that you can recognize emotion.

A way to understand empathy is one that I carried with me throughout my active ordained ministry and still use today. When I express empathy towards another who is hurting (whether spiritually, physically, or mentally) I picture the person who is hurting in a deep dark well (kind of like the one in the Brown cartoon above). I picture myself empathetically entering the well with the person to sit with them in their pain, but I also always picture the rope that maintains a connection to the outside. I picture that rope tied securely outside the well, and I hold onto while in the well. If you as the helper/healer do not maintain the grounding lifeline, the way out of the well, you will both just be wallowing in the darkness.

Thank you Dr. Berger for the thought provoking writing!

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