Resistance to empathy takes many forms. Resistance to empathy includes those factors coming from
the therapist, those from the patient, including those emerging in
the interaction, and those from the culture at large. Although
“the culture” is distinct from “the system delivering mental
health services” and differentfrom Racker’s “countertransference
to the psychoanalytic organization,” especially by those
in training (Racker 1968), for purposes of this discussion, the
three are considered together. They are ideal types and mixed
cases are frequent. This article engages the details of resistances
to empathy. Clinical cases exemplifying empathic narratives,
as one patient expresses it, of the “Freud [sic, fraud] of
psychiatric diagnosis”and related are explored.
Empathy and Its Inauthenticities
This is the ultimate inauthenticity. The author of a book on empathy struggles with his empathy. Introducing
myself saying, “I am the author of a book on empathy, and you can count on mine” gets a rise out of people.
It sounds like “empathy lives over here by the author of this article.” Over there – “over there by you,
the reader”is lack of empathy. Of course, that is a misunderstanding. The commitment in engaging
empathy and its resistances it to expand the possibility of empathy and the extent of empathy in the
world. On a good day, one does get all the way to empathy – all the way to a gracious and generous
listening. Then one has to complete the loop, close the circle. One demonstrates to the other person
that one relates to the other and acknowledges
the other’s humanity, as a possibility, in the struggles and accomplishments the other has expressed.
On a less good day, one struggles along with everyone else. One is subject to the inauthenticities of
empathy like everyone else – that one is a wonderful listener, that others admire and idealize one, that
one’s guidance is golden. If there is self-deception about the extent and depth of one’s empathy,
then can resistance be far behind?
Empathy is one of those things like motherhood and apple pie that every person endorses.
How could anyone be against them? What’s not to like? Yet when it comes to my mother or your mother
or this tasty looking calorie-laden dessert totally at odds with one’s commitment to taking off five pounds,
maybe it is not such a good choice. It reminds one of Thomas Ogden’s patient, who, at the start,
associates to misadventures and slips suggesting maybe this process of psychoanalysis is not such a
great idea after all. Or the therapist who is not afraid that the patient will leave, but rather afraid that
he will stay(Ogden 1992: 228). In short, there is a suspicion that there is more ambivalence about
empathy than initially meets the eye. In turn, the ambivalence recruits enactments – confrontations,
canonical advice, prescribing medications (or referrals for such) when not really required, affixing devaluing diagnostic labels (“borderline,” comes to mind) when the individual is merely “reactive” and “difficult,”
or speaking ex cathedra as the authoritative decoder of meaning instead of the empathic inquirer.
Once again, I know that I am not the only one struggling but I too struggle with the ultimate
inauthenticity of listening. One is not listening to what the other said. One is listening to his own
opinion of what the other person has said. One is listening to one’s opinion of whether one agrees,
disagrees, values, devalues, or how it reminds one of something else that one then judges and
evaluates. These judgments too get in the way, and are recruited by narcissism to form resistance
to empathy. The resistance is subtle. It is rarely acknowledged. It is pervasive. One key to overcoming
– or at least managing – the ultimate inauthenticity is to take the
focus off of oneself. Empathy lives in relatedness – as the foundation of the community of interrelated
individuals, even as the dynamic duo of the psychoanalytic and psychotherapeutic conversation.
In short, empathy LIVES at the IPA. Join me in person for a dynamic and interactive session!
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