Empathy at Grand Rounds – the movie (educational video)

The rumor of empathy is no rumor of the work being done at Rush Medical Center, Northwestern Feinberg School, and the University of Chicago Graham School. Empathy LIVES there – check it out in the following educational videos….

(1) Here is an educational video of the talk on empathy at Rush University Medical Center October 13, 2016

(2) Here is a talk on empathy at the University of Chicago Graham School of Continuing Education delivered on Bastille Day (July 14th 2016) –

(3) Here is a video of the talk on empathy at Northwestern University Feinberg School on September 17, 2016

For those readers of this blog who just like to read, here is the draft text of the talk about Empathy and Literature.

The reason that I have spoken of the secret underground history of empathy is that the word itself in English “empathy” was not invented until a Cornell University psychologist, Edward Bradford Titchner, was translating (1895) one of the innovators who are credited with founding psychology as a science, namely, Wilhelm Wundt – and Titchener invented the word “empathy” to translate the German “Einfühlung”.

The philosopher David Hume, never a stickler for consistency, has at least five different definitions of the word “sympathy” in his Treatise of Human Nature (1739). (1) “Sympathy” means emotional contagion. Hume gives an example of being a guest and joining a party of happy people. One feels happy. Likewise, if I am with a person who is melancholy or down in the dumps, one feels sad. This is not empathy – but describes a receptivity of openness to other people’s experiences. However, the mechanism promoting emotional contagion provides input to the process of empathic receptivity. (2) “Sympathy” means suggestibility. When a friend or colleague gives one advice, that is not empathy but our sympathy for our friend or colleague makes us inclined to consider the possibility (or suggestion) they are offering. This suggestibility is balanced in Hume by taking a General Point of view – similar to a detached ideal observer who is nevertheless not a cold-hearted egoist. We put ourselves in the place of a general point of view, which corresponds to the Folk Psychology definition of empathy – talk a walk in the other person’s shoes. (3) Hume identifies “sympathy” as the operation by which one person has the experience of another person’s experience. One has a representation or impression of the other person’s impression. But if one stops there the experience falls back to emotional infection or contagion. To arrive at full blown sympathy, one must have a representation of the other’s representation plus the representation (idea) that the other person is the source of the experience. So Hume speaks of a double representation in sympathy. This is what operates in forming a “vicarious experience” of the performers in the theatre where one experiences their experiences but does not jump up on the stage to intervene in the drama and rescue the hero or heroine who is about to be dispatched by the villain. (4) In Hume’s later work, “sympathy” migrates in the direction of benevolence – responding in a compassionate way to the suffering of other, by which it becomes the foundation for morality for Hume. Now the world definitely needs more compassion – but it is distinct from empathy. (5) Hume distinguishes a “delicacy of sympathy” in friendship from a “delicacy of aesthetic taste” in the appreciation of beauty. Then he attributes to a “delicacy of taste” all those features of human relationships such as being a good friend to a “delicacy of taste.” “A delicacy of sympathy” comes to mean irritable, irascible, or grouchy – being a difficult individual – what today we might describes as the over-sensitivity of an empathic person whose emotions are dis-regulated. Hume attributes to what he calls a “delicacy” (in any form whether of sympathy or taste) of [aesthetic] taste” to fine-grained aspects of experience. If you perceive an ambivalence and (say) a sadness beneath my anger where everyone else only perceives the anger, then your delicacy of sympathy is more refined than mine – what we would today call your “empathy” is more expansive. For a medical audience, it may be useful to think of the fine-grained attention to detail that constitutes part of a mental status report.

Hume has a wonderful story that illustrates the fine-grained detail of experience in its relation to a delicacy of sympathy and of taste. Wine and sherry experts are trying a cask of sherry – and the one expert says it is fine Sherry but it has a hint of iron – and everyone laughs at him The other expert says it is a fine Sherry but it has a hint of leather to it – and the laughter grows even louder. Now the group drinks all the sherry – and drains the cast – and – low and behold – a rusty key on a leather thong is discovered. The two individuals perceived something that the others did not perceive – their delicacy of taste was more refined.

Immanuel Kant famously said that Hume awoke him from his (Kant’s) slumbers. Kant is often accused – I think, unfairly, of being a formalist – and in the 1780 and early 1790s the other person shows up in Kant’s writings as an example of the moral law who must be treated as an end in her- or himself and not as a mere means. When I encounter the other person for Kant, I encounter the moral law. But a reconstruction of an account of empathy opens up in Kant when we turn to his approach to the appreciation of beauty – when you and I appreciate the same representation of natural beauty there is a communicability of feeling between us. That is in effect phase one of empathy. Two individuals We have a certain distance and disinterested from the experience of the free play of our imagination and understanding as it is inspired by the judgment about the beautiful as we experience it. This experience is necessary and universal and accessible to all human beings in so far as we share a sensus communis – a common sense not in the folk psychology sense of “be sensible” but as a common sensorium that all humans share because we bring shared capacities to sensing, feeling, and thinking that we all share. Thus, Kant speaks about enlarged thinking “to put oneself in the place of the other person,” which is precisely the folk psychology understanding of empathy. Empathy works both top down – taking a walk in the other’s shoes – and bottom up – experiencing the experience of the other person vicariously. Kant identifies ways this process can fail and mis-fire, which seem to be built into the imperfection of human judgment. Kant identifies the tendency of all human beings to project their feelings into nature – thus we speak of a raging storm at sea; a tranquil sunset; a melancholy clearing in the forest; majestic mountains (“majestic” refers to his majesty the king).

This tendency to anthropomorphize seems to be a design defect in human beings resulting in the fundamental attribution error – in effect a breakdown in empathy whereby the other takes on attributes of oneself without necessarily deserving such an attribution.

The thinker who really runs with the ball in the Munich psychologist, Theodor Lipps. Lipps is responsible for popularizing the use of empathy (prior to 1914 (WW I)). Remember the movie Amadeus? Lipps is the equivalent of Antonio Salieri to Freud’s Mozart. You know how in the movie Amadeus, Salieri is famous and Mozart is toiling away in obscurity; whereas today Mozart is recognized and played by orchestras all over the world and, except for the movie Amadeus, Salieri is unknown and infrequently performed? Likewise with Lipps and Freud. Lipps was a man celebrated and famous in his day, but is now unknown; whereas Freud is a household word, even if his psychoanalysis has fallen on hard times as a treatment.

Lipps contributes to keeping empathy from breaking out into widespread adoption precisely by being so successful in owning the term in his own idiosyncratic way. Basically, Lipps substitutes the term “empathy” for “aesthetic taste” in his Psychology of Beauty and Art (Aesthetic (1903)). Beautiful art inspires in the human body a kind of muscle mimicry such that we ourselves attribute to the art work the experiences of soaring, enlivening or constraining and devitalizing that are activated by the art work or example of beautiful nature. The art work inspires and gives one access to the experiences of our own feelings of the furtherance of life.

In terms of empathy as we know it today, namely, getting access to the experiences of the other person and processing those experiences further and cognitively, is disregarded by Lipps in favor of constructing the other person out of traits and characteristics of one’s own self. In a philosophical context, the name for this fallacy is solipsism – there is nothing in the world but one’s very own self. However, Lipps argues that all psychological functions and processes were unconscious – and this made him of interest to Freud.

But Freud was his own man. He could not use Lipps’ term “empathy” – though Freud’s methods were highly empathic and his listening engaged deeply with the other – without being mistaken for a follower of Lipps. That of course Freud would never allow. Thus, there are only twenty-two mentions of the word “empathy” [Einfühlung] in the twenty four volumes of Freud’s Standard Edition – though, as noted, Freud’s methods were highly empathic. Freud states in his paper on Recommendations for Physicians Beginning the practice of Psychoanalysis (1912) that “it is certainly possible to forfeit this first success [in therapy] if one takes up any standpoint other than one of empathy such as moralizing” (1913: 140). However, the use of empathy in this instance as well as virtually all the mentions in any clinical context is mistranslated by James and Alix Strachey, who separately in their letters to one another make devaluing comments about the word “empathy” – and the word “empathy” itself does not occur. (Note that the word does make it into the Standard Edition in the context of Freud’s writings on humor and aesthetics where he is directly footnoting Lipps.)

It was only when the phenomenologists such as Edmund Husserl, Max Scheler, Martin Heidegger, and Edith Stein, undertook a sustained and years long critique of Lipps’ theory of “projective empathy” – a devaluing term if there ever was one – that empathy became free of Lipps’ baggage, enabling our modern uses that are featured in Carl Rogers, Heinz Kohut, and others to emerge.

Thus, the short history of empathy of empathy.

How does empathy live in the listening and understanding of the everyday person on the street?

Here I have some data ….

I have done some survey work, having students in a class go out an ask some five people that they know who are not family members or close friends to define empathy without telling or suggesting an answer: While often I have been known to say that we do not need more data, we need expanded empathy. Sometimes we need both. In this case, a distinctive tend emerged: an overwhelming majority of people – some 80% indicated that “empathy” means a cluster of distinctions such as “compassion,” “altruism,” “charity,” “helping someone in need,” or generally being ethical in a prosocial way of helping others in need. Now, heavens knows, the world needs more compassion. However, empathy is distinct from compassion.

If the other person with whom I am working is suffering and I have a vicarious experience of the suffering, then I am going to suffer – but strange as it sounds, not too much. If I am over-whelmed by the suffering, I am doing it wrong – I should expect to suffer, but strange as it sounds – not too much. That is the training – and it belongs in the “easier said than done file.”

So let’s engage in more detail. So if I am working with someone who is suffering (for any reason), my natural empathy will pick up on that suffering as a vicarious experience, a sample of their suffering, as a trace experience, affect, feeling or emotion. However, from the perspective of empathy, if I am suffering not just vicariously as if I were seeing the movie trailer of their life, but quantitatively and substantially as they are suffering, then I am doing it wrong. Empathy has mis-fired and gone down the slippery slope to merger or total identification. Strange as it sounds, if I am empathizing, then I may suffer, but not too much. The empathic method uses the vicarious experience of the other person to make a difference in shifting the other person out of suffering, understanding their attachment to their suffering, and surfacing a possibility for relatedness where there previously did not seem to be a possibility.

This is the approach by which empathic methods act as a filter to the experience of the other person. The expert user of empathic methods is able to expand or contract the granularity of the empathic filter of the other person’s experience to capture a vicarious experience that is more or less lively and forceful and vivacious.

In short, empathy tells me what the other person is experiencing; compassion and ethics tell me what to do about it. Here is the conversation about dis-orders of empathy such as psychopathy, socio-pathy, or being on the Asperger’s and autistic spectrum. Here is the conversation about using empathy to increase the suffering of the person being interrogated as the American Psychological Association sends clinical psychologists to Guantanamo. Simon Baron-Cohn has done work in the area with his work on Mind Blindness and Zero Degrees of Empathy.

So, best practice, let’s define our terms. How is empathy defined? We will distinguish and engage with empathy in terms of four dimensions: empathic receptivity, empathic understanding, empathic interpretation, and empathic responsiveness. We will circle through these a couple of times. Each has a characteristic paradigm, ideal type, case, or example. The minimal essential constituents of the unified, multi-dimensional definition of the process of empathy include: (1) a receptivity (“openness”) to the communicability of the affect of other people whether in face-to-face encounter or as artifacts of human imagination (“empathic receptivity”), the paradigm case of which is vicarious experience and feeling; (2) an understanding of the other individual in which the other individual is grasped in relatedness as a possibility—a possibility of choosing, making commitments, and implementing them (“empathic understanding”) in which the aforementioned possibility is implemented, the paradigm case of which is relating to the other as a possibility, not someone to be used for a give purpose or enrolled or studied theoretically or practically or made the target of a sales pitch; (3) an interpretation of the other person that identifies patterns of adaptation and templates of survival from first-, second-, and third-person perspectives (“empathic interpretation”) by means of the mental mechanisms of a transient identification with the target of empathy and a splitting into a participating and observing sector, resulting in the general view of an general observer (the paradigm case of which is taking a walk in the other’s shoes); and (4) an articulation in optimal responsiveness in behavior and speech, including speech acts, of this receptivity, understanding and interpretation, including the form of speech known as listening that enables the other to appreciate that he or she has been the beneficiary of empathy (“empathic responsiveness”) (which takes us back to the start – empathic listening). (See Figure 1 The Hermeneutic Circle of Empathy on the handout.)

Thus, empathy is being unpacked into – empathic receptivity, empathic understanding, empathic interpretation, and empathic responsiveness.

Thus., once again, in summary: Empathic receptivity is openness to the other in the form of vicarious experience of the other’s experience – as in David Hume, I have a representation of your representation plus a representation that the experience is that of another person, in this case, you. Empathic understanding is further cognitive processing of that experience, specifically in the form of what possibilities are disclosed by the experience – the experience shows what is the implicit and undeclared commitment – the project in the background to which the individual is committed as a possibility. Empathic interpretation is further processing of empathic understanding whereby the undeclared and implicit possibility is made explicit from the perspective of first person, second person, third person perspectives. This is the Folk Psychology definition of empathy in which the one person talks a walk in the other person’s moccasins – takes a walk in the other person’s shoes. Finally, one can be perfectly empathic, but if no one else knows about it, empathy becomes the tree falling in the forest when no one is listening – it does not make a sound. Empathic responsiveness takes the other person’s experience as captured in empathic receptivity, empathic understanding, empathic interpretation, and gives it back to the other person in a form of words or related articulate expression. The other person then has the opportunity to experience their own experience as coming at them from another – and the other person gets to say whether or not she or has been “gotten” in the sense of an empathic encounter. If not or if the empathy is incomplete, partially accurate, or just plain missing the point, then the processes is iterated. This is the moment of confirmation or disconfirmation, testing the accuracy of one’s empathy. Go back to the start and around in the circle again.

Paradoxically the form in which empathic speech comes into language is as listening. One has to be quiet and quiesce the inner verbal chatter in one’s verbal thinking in order to give full attention to one’s listening. One has to still – quiesce (as I put it) – the verbal voice over to listen: “I can’t hear you because my opinions and judgments about what you are saying are so loud.” “You can’t hear me because your inner voice over of judgments and evaluations is so loud.” The exercise is not to resist the opinions and assessments, since that seems to make them more intense, but to distinguish them and acknowledge that such chatter is not who one is authentically. Distinguish them and they lose their power, and one is able to be fully present with the other person and listen to what they are saying.

Now one powerful and significant advantage of this multi-dimensional definition of empathy is that each phase has its characteristic way of failing, breaking down, going off the rails, or otherwise mis-firing. And whenever there is a breakdown there is the possibility of a break through. Wherever there is a breakdown there is the possibility of intervention, tuning, adjustment – in short, training.

So now I am going to propose something different. I am going to look at all four phases of empathy – which indeed exist virtually simultaneously – and the empathic receptivity does come at the backend but is present implicitly in the expert from the first moment – with specific reference to empathic breakdowns and potential breakthroughs in examples from literature.

In short, I am going to tell some stories. Empathic narrative.

I am going to create the context for the conversation with some background.

In Thomas Mann’s Buddenbrooks, published in 1900, Thomas Buddenbrooks is a successful business person who gave up his emerging artistic career to run the family business. However, he has compensated for not having an artistic career by marrying one – his wife Gerta is a talented, passionate musician, who plays passionate violin duos with her father (and others). They have a son Johann or Hanno who is about eight years old – pre-pubertal. Hanno is a chip off the old block – artistically talented but socially awkward and sickly with numerous childhood diseases and bad teeth. In Thomas Mann’s writings bad teeth are a thematic indication of artistic talent – and perhaps a symbol of challenges in oral self-expression and passive-aggressive ambivalence about grabbing the nipple of life so to speak and sucking for all one is worth. The strapping Nordic types at school tease and bully Hanno. He struggles with his studies and tends to break down in tears as his father cross examines him about his multiplication tables. He is miserable. The conflict? Hanno has to be prepared for a business career – but he hates business. He breaks into tears every time he has to recite his lesson for his “hail fellow well met, boot camp” father who is preparing him for the rigors of finance and marketing. Slightly different than a medical student giving a crisp incisive diagnostic report to an attending physician or resident, but perhaps not by much. Hanno falls apart and bursts into tears.

First we are going to look at empathic receptivity and then at empathic understanding.

A vignette of empathic receptivity (and resulting empathic distress) in Mann’s character of the dentist, Herr Dr. Brecht, whose would-be empathy for his patients misfires and degenerates into emotional contagion that is such that he (Dr. Brecht) breaks out in a cold sweat and has to sit down exhausted after each dental procedure. In short, Dr. Brecht has available the vicarious experiences that would make him a good empathizer if he were able to control them; but, being endowed with an especially sensitive, delicacy of empathy, instead Dr. Brecht falls prey to emotional contagion, empathic contagion. Here is the exact quote:

The bad thing about Dr Brecht was he was nervous, and dreaded the tortures he was obliged to inflict. ‘We must proceed to extraction …,’ he would say, growing pale. Hanno himself was in a pale cold sweat, with staring eyes, incapable of protesting or running away; in short, in much the same condition as a condemned criminal. He saw Herr Brecht, his sleeve, with the forceps, bend over him, and noticed that little beads were standing out on his bald brow and that his mouth was twisted. When it was all over, and Hanno, pale and trembling, spat blood into the blue basin at his side, Herr Brecht too had to sit down, and wipe his forehead and take a drink of water.” [1]

Dr Brecht is not self aware of how he is picking up the suffering of his subjects and may usefully take steps to tighten the granularity of his empathic filter. Dr Brecht’s response seems to be his natural biological disposition to be open to the experiences of others – perhaps rather like the person who sees blood and faints – only Dr Brecht does not faint but breaks out in a cold sweat. Bad joke (right?): Maybe he should have gone into psychiatry or ophthalmology!? He needs to get in touch with the source of the feeling – it is the other person, not himself. And remind himself that he is safe and no one is probing his mouth with sharp instruments. On the contrary, he is providing a valuable service. In a sense, he is insufficiently over-intellectualizing, and he may usefully over-intellectualize, though in circumstances of losing touch with his feelings and experiences over-intellectualization would be counter-productive. Here it would be useful.

In the next example we engage empathic understanding. Thomas and his wife, Gerda, have moved away from the town in which Gerda and her family lived. She is separated from her father with whom she played complex virtuoso violin duos. But she meets someone who is willing and able to practice with her – The Lieutenant. She takes up playing duos in the music salon above Thomas’s home office in the back of the big house where he is working. In this scene, Gerda and the Lieutenant are upstairs playing passionate, virtuoso violin duos and then the music stops. The music stops … are there is silence … more silence … nothing but silence. The silence continues … and continues. Thomas does not dare become the caricature of a jealous husband, whereby he would lose status with his wife. But he is tortured by the silence and he is pacing back-and-forth in the hallway. He runs into Hanno:

But his father did not seem to be listening. He held Hanno’s free hand and played with it absently, unconsciously fingering the slim fingers. And then Hanno heard something that had nothing to do with the lesson at all: his father’s voice, in a tone he had never heard before, low, distressed, almost imploring; “Hanno—the lieutenant has been more than two hours with Mamma.” Little Hanno opened wide his gold-brown eyes at the sound; and they looked, as never before, clear large, and loving, straight into his father’s face, with its reddened eyelids under the light brows, its white puffy cheeks and long stiff moustaches. God knows how much he understood. But one thing they both felt: in the long second when their eyes met, all constraint, coldness, and misunderstanding melted away. Hanno might fail his father in all that demanded vitality, energy and strength. But where fear and suffering were in question, there Thomas Buddenbrooks could count on the trust and devotion of his son. On that common ground they met as one.[2]

“Their eyes meet.” That is the moment of empathic receptivity embedded in empathic understanding. The father who was so inaccessible in his “hail fellow well met” and boot camp style “cross examination” of Hanno about his lessons becomes vulnerable and accessible in his suffering . Hanno “gets” his father’s vulnerability as a possibility – a possibility of his humanity. They share a human moment. The possibility of relatedness emerges in which both are human beings and in emotional connection with one another. This had not been available to Hanno before – for whom his father was this strong, demanding task master. Now he sees the father’s vulnerability- and it humanizes both of them. This is also an example of empathic understanding that works – to an extent.

A single moment is a good start. It points to a possibility of empathic relatedness. And Hanno’s own empathy for his father is activated. But he is just a kid and does not appreciate the sexual symbolism of “making music” together. His empathic understanding is incomplete. And Thomas’ empathic understanding is also limited. By all means be vulnerable but do not necessarily expect a child to appreciate the context. When empathic understanding breaks down, one gets egocentrism or projection or both – and that’s what we have on the part of Thomas who wants to make Hanno a “chip off the old block” when he is totally unsuited for the role of business person. It is not easy being the off spring of a conventionally successful parent.

The third example engages empathic interpretation. Here we turn to Edmond Rostand’s Cyrano de Bergerac (1897) – also a major motion picture (“Roxanne”), starring Steve Martin as the large-nosed protagonist.

Cyrano seems to give up hope of winning the love of Roxanne because of his unattractive nose, his social awkwardness, and the fact that she has fallen for his friend, Christian. Instead Cyrano woos Roxanne vicariously through the more superficially attractive Christian – he is buff, a real Justin Beeber type – by putting his own skills as a poet and noblemen at Christian’s disposal. Cyrano writes the love letters and poems and expression of affection that persuade Roxanne to agree to a romantic rendezvous.

In a climactic scene, Roxanne is on the balcony above and Christian is down below – a cliché out of Romeo and Juliet – in the dark and (unbeknownst to Roxanne) accompanied by Cyrano. Christian gets tongue-tied – he is perhaps not the brightest bulb in the chain though he is the cutest – and Cyrano actually speaks for him, assuming his voice and cadence. This is role playing and changing perspective run amok. The transient role reversal, living vicariously through another, and perspective taking of empathic interpretation becomes out-and-out identification physically. Note that it is completely credible that Roxanne would find Christian to be “in character” since, all along, it is Cyrano who has been writing his letters and love poems. Roxanne is in love with the author of the letters and poems she has been sent. Christian is really a puppet whose strings are being pulled by Cyrano , who hopes that Roxanne sees through the superficially attractive but dumb Christian to the real humanity that lies within him (Cyrano). Such is not to be. When she invites him to join her, it is Christian who the stage directions call to mount up and climb up the balcony. The language is significant.

Alas, love is blind, even if empathy is not. Cyrano’s empathic interpretation of the possibility that Roxanne will see through Christian, the pretender to Cyrano’s authentic, “real deal” self is rendered ineffective. Cyrano might have risen to the level of empathy – he is receptive enough to gather the relevant experiences – but his empathy is inhibited by his low self-esteem and social awkwardness.

The final example is of the vicissitudes of empathic responsiveness. In Tennessee William’s play The Glass Menagerie (1944), Laura is a fragile isolated young lady – like her collection of delicate glass animals – she is on the shelf and life is seemingly passing her by. Her mother, once an attractive magnet for gentleman callers but now a faded, over-bearing and competitive person, looking to live vicariously through her daughter but unable to do so because frustrated by Laura’s shyness, pressure her son, Tom, to invite his friend from work to dinner. The invitation is accepted. At last – a gentleman caller! The problem is that Jim thinks it is just a casual dinner with his friend Tom, who, as noted, has been pressured by Amanda to help find a gentleman caller for Laura. No one knows that Jim is already engaged to be married. Jim comes to dinner innocently enough to find that Laura is Tom’s sister. Laura and Jim went to grade school together. She had a crush on him. He remembers her, alright – by the name of Blue Roses. Laura was sickly – one of the illnesses that kept her out of school was pleurisy – and, as a boy, Jim heard and remembered the name as “Blue Roses” – that is, “pleurosis.” The infatuation is incidentally rekindled on the part of Laura and Jim is a genuinely warm and affectionate person. She confides in him about another of her illnesses (polio) that left her with a slight limp. To Laura, as she walked down the aisle in the auditorium at school, her uneven gait echoed as a thunderous Thump, Clump, Thump, Clump; whereas to Jim and the others it was barely audible. Laura defines herself as this defect. Her experience of herself is as this Clump; whereas Jim’s experience of her was as “Blue Roses.” Something broken versus something beautiful, even if a tad melancholy. And the brilliance of Williams’ writing enables us to get inside her experience. And it also enables us to get inside the experience of Jim as he experiences Laura. His empathic responsiveness captures his experience of her as “Blue Roses”. When he gives her back his experience of her – not a broken gait (step) but something beautiful – she comes alive for a short while – until she learns he is unavailable. The empathic responsiveness is incomplete – for so many reasons – including the playwright’s commitment to leaving the audience with the emotional devastation to which he is so attached and trying to work through by writing the play.

Now as an exercise I am asking you to be quiet and listen to yourself. Let me say a tad more about that. As I walk down the street and pass people I notice that I am judging and evaluating. I have an opinion about everything – he’s cool, she’s cool; how did he get to look like that; what did she do to be that way. Notice that does not tell you very much – but it says volumes about me – I am ashamed of the devaluing judgments, evaluations, opinions, assessments that I have just walking down the street. That is not who I authentically am – that devaluing talk is not who I authentically am as a possibility – that ongoing voice over conversation is not even authentically me. And the good news that when I meet a person I relate to that person as a possibility not to my devaluing opinion (if such an opinion is what happens to be occurring at the moment).

This is an exercise in introspection. My reaction to another person – annoyance, affection, hostility, boredom, compassion, love hatred, fear, sadness – tells me as much about myself as it does about the other. [Now when I speak about myself I am not just talking about me – I am asking you to try it on – to listen like I am taking about you too.] It may be that humans are designed that way – for example, in the environment of evolutionary origin – to form a quick not necessarily fair judgment to avoid false negatives – it is better to mistake the sunlight dancing on the tall grass for a tiger than to mistake the tiger for sunlight dancing on the tall grass (in which case I would fall prey to becoming lunch). Nevertheless, the voice over running commentary is pervasive – and I am not asking you to resist it or try to stop it – with practice one can get it to shrink but probably never to go away completely – what the exercise asks you to do is simply to distinguish it – distinguish it from who you are – and acknowledge that is just another thought – just another opinion.

If one goes far enough inward in introspection, one finds the other. It is a myth that we are unrelated. Positively expressed, we are all related. That individual who really rubs me (or you) the wrong way – we are related. The one who pushes your hot button and vice versa we are related – and the button is essential part of the relatedness. Rene Descarter (1648) – the philosopher of the isolated consciousness disconnected from the world that may not exist – Descartes the philosopher of solipsism – that there is no other consciousness in the universe except my own – missed the essential relatedness to the other by which I (and you) define who we are. So much for Descartes.

The exercise: not how to listen better – rather how to expand one’s listening: “I cannot hear you but I am constantly talking so loud to myself about my opinion of what you are saying.”

Let us be quiet for thirty seconds and listen to the inner voice. Okay. Go.

Times up. What did the voice say? … [“What voice?” “Where did this guy come from?” “What the heck is going on?”]

When a person distinguishes the noise and the inner voice over and the judgments and evaluations, then what is left is an opening – a space – to be with the other person and listen to what she or he has to say. That is the empathic moment – just to be with the other individual without adding anything else – and to respond out of the emptiness of possibility – out of what is possible. That is the ontological definition of empathy – to be in the presence of another with nothing else added – no categories, no labels, no philosophical arguments, no hermeneutic circles – just be with the other.


Lou Agosta. (2015) A Rumor of Empathy: Resistance, Narrative, and Recovery in Psychotherapy. London: Routledge.

Sigmund Freud. (1913). “Further Recommendations on Beginning the Treatment,” Standard Edition 12: 121 – 144.

David Hume. (1739). A Treatise of Human Nature, ed. L. A. Selby-Bigge. Oxford: Clarendon Press, 1973.

__________. (1741). “Of the delicacy of taste and passion” in Of the Standard of Taste and Other Essays, Indianapolis: Bobbs-Merrill: 1965.

__________. (1751). Enquiry Concerning the Principles of Morals in Hume’s Moral and Political Philosophy, ed. H.D. Aiken, New York: Hafner Publishing, 1968

__________. (1757). “Of the standard of taste” in Of the Standard of Taste and Other Essays. Indianapolis: Bobbs-Merrill: 1965.

Edmund Husserl. (1905/20). Zur Phänomenologie der Intersubjectivität: Texte aus dem Nachlass: Erster Teil: 1905-1920, ed. I. Kern. Volume XIII. The Hague: Martinus Nijhoff, 1973.

______________. (1921/28). Zur Phänomenologie der Intersubjectivität: Texte aus dem Nachlass: Zweiter Teil: 1921-1928 ed. I. Kern. Volume XIV. The Hague: Martinus Nijhoff, 1973. 

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_____________. (1918). Ideas Pertaining to a Pure Phenomenological Philosophy: Second Book, tr. R. Rojcewicz and A. Schuwer. Dordrecht: Kluwer Academic Publishers, 1989.

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[1] Thomas Mann. (1901). Buddenbrooks, tr. H. T. Lowe-Porter. New York: Random House, 1961: 403–404.

[2] Buddenbrooks. (1901): 507; translation modified slightly.

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