Wednesday, November 13, 2013

Sympathy, Empathy and Being-for-Others

As a palliative medicine specialist, I am often asked to comment on the human qualities of sympathy and empathy. In particular, the question is often how can we ‘teach’ those charged with caring for the seriously ill and dying to be more sympathetic, empathetic, or at least how to have these workers seem to be sympathetic, empathetic. There is the potential for great benefits here, benefits for all, especially if we work from a system in which we are most truly who we are as humans when we are being for the ‘other.’


First, I should define my terms: by sympathy I mean that human quality that enables us to participate compassionately in the feelings or suffering of another, to allow those feelings and suffering to resonate within and  between ourselves and the other person; by empathy, I mean that rather extraordinary human quality that enables us to experience the feelings or suffering of another. I do not wish to commit psychology here, but these terms cannot be synonymous, even though they both involve compassion and the ability to form a response to the suffering of ‘the other’. Further, making distinctions among the types of sympathy and empathy (e.g., affective and cognitive empathy), or discussing psycho-pathologies that eradicate the capacity for sympathy and empathy, are tasks for another place and time.


All human beings who are psychologically and spiritually intact are capable of sympathy and empathy, and these qualities are likely hard-wired into humanness itself. Still, unsympathetic and un-empathetic behaviors often come into play, and in clinical situations, can be detrimental to the well-being of patients, their families and co-workers. Certainly, when such behaviors occur during the care of the gravely ill and dying, the stakes are even higher, as time tends to subvert recovery. These behaviors often result from misapprehending the situation, poor prioritization of needs, and a shift away from the other to the self. Workers who display such behaviors are not psychologically ill or otherwise pathological, but often preoccupied with a distorted hierarchy of needs.


Apart from educating professional and family care-givers caring for the seriously ill and dying (hospice patients, for example) in a patient-centered value system, and prioritizing the needs of the sufferer other over and against the needs of a beleaguered worker who simply has to get to the next patient, what else can be done to bring such caregivers in touch with their innate capabilities to sympathize and empathize?


Permit me to borrow a concept from early Christian literature: kenosis. From the Christological hymn in Philippians 2, the concept is one of self-emptying; moreover, it is a directed self-emptying, an emptying whose purpose is to take on another nature. A brief consideration of the text would be helpful:


Do nothing out of selfish ambition or vain conceit. Rather, in humility value others above yourselves,  not looking to your own interests but each of you to the interests of the others. In your relationships with one another, have the same mindset as Christ Jesus:

Who, being in very nature God,
did not consider equality with God something to be used to his own advantage;
rather, he made himself nothing
by taking the very nature of a servant,
being made in human likeness. [NIV, Phl 2:3-8]

The phrase, ‘made himself nothing by taking the very nature of a servant’ captures the concept of kenosis nicely. Theologically, of course, the passage cannot be read as an exchange of the divine for the human, but rather as a divine accommodation of another nature. The Christological and soteriological richness notwithstanding, the process of kenosis can be utilized, at least metaphorically, to bring people in touch with their own capacity for sympathy and empathy.

So, then, can sympathy, empathy and compassion be taught? Perhaps: to the extent that a caregiver can participate in the metaphor of kenosis, he can conceptualize his own self-emptying to allow room for the participation in the feelings, emotions and suffering of the ‘other;’ more specifically, to make room for those feelings of the ‘other’ within himself. Through this confrontation with the suffering of the other within himself, an appropriate response can be formulated and expressed as a sympathetic/empathetic gesture or word. Thought of in this way, sympathy and empathy can be related by degree, or on a continuum, rather than by essence: the greater the emptying, the likelier it becomes to move from compassionate participation and well-wishing to actual experience of and responding to the suffering in the ‘other’. In this way, the move from sympathy to empathy is less paradigmatic, and more syntagmatic, less a change of scene, and more an extended viewing along the horizon. This process is of course easier to state than implement, but considering the task before caregivers and the needs of the seriously ill and dying, the process is well-worth the attempt.

 Coda: For non-religious caregivers, no theological point need be made, but rather a participation in the celebration of the wonder and beauty of being human. For religious caregivers, and perhaps especially for Christian caregivers, the theological, Christological and soteriological depths of this kind of imitatio Christi can be fulfilling beyond the joy of humanism. Indeed, self-actualization, emotional and spiritual growth, and participation in individual and collective humanity are merely the surfaces of being ourselves and being true to ourselves by being for others.