Empathy

When you witness a widow wailing, do you feel grief?

When you observe the ecstasy of a lover, do you feel pleasure?

When you see a child fall and scrape her elbow, do you feel pain?

When you encounter a man celebrating good fortune, do you feel joy?

Empathy is the ability to reciprocate the experience of another human being.  

This experience takes the form of movement, thought or feeling.

Motor empathy refers to reciprocation of movement. This most primitive form of empathy underlies the basis for physical imitation. Without the ability to simulate the actions of others, you would find it quite difficult to learn how to drive or take a new dance class.

Cognitive empathy refers to reciprocation of thoughts. The ability to embody thoughts of another person proves essential to engaging in meaningful conversation. Without the ability to understand your opponent's perspective, it would be difficult to resolve a disagreement.

Emotional empathy refers to reciprocation of feelings. Tapping into the emotions of others--anger, pain, hunger--drives pro-social behavior that benefits the group overall. Without the ability to feel despair, you would be unlikely to help a neighbor in need. 

 
 

On Empathy:

  1. The evolutionary basis for empathy

  2. brain pathways underlying empathy

  3. my practice of empathy

 

The Evolution of Empathy

[Humans] are exquisitely social creatures ... survival depends on understanding the actions, intentions and emotions of others
— Dr. Rizzolatti, NYTimes

EMPATHY BREAKS BOUNDARIES BETWEEN BRAINS.

The ability to reciprocate thoughts and emotions is essential to the human experience. Empathy is a pro-social tool employed to facilitate cohabitation. Empathy enables an individual to overlook his self serving agenda in favor of group interest.

The ability to empathize with a distressed group member will significantly increase the likelihood of aiding that individual.

Empathy increases the chance for group survival.

A lack of empathy leads to interpersonal disruption, encountered in a variety of neuropsychiatric conditions. Cox et al reports a tendency to lack cognitive empathy among individuals with autism, bipolar disorder and borderline personality disorder; whereas, individuals suffering from psychopathy, schizophrenia and narcissism tend to lack emotional empathy.

 

Neural Networks of Empathy

 Discovery of mirror neurons invites a neuroscientific understanding of the saying, "Monkey see, monkey do". Mirror neurons may be the basis for imitation, the process by which humans learn to do, essentially, everything (Iacoboni). Image from psu.edu

Discovery of mirror neurons invites a neuroscientific understanding of the saying, "Monkey see, monkey do". Mirror neurons may be the basis for imitation, the process by which humans learn to do, essentially, everything (Iacoboni). Image from psu.edu

Brain imaging studies suggest a neural basis for empathy: mirror neurons.

Mirror neurons are brain connections that fire both when an animal performs an action and when an animal witnesses the action being performed.

As an example, consider the action of waving to a friend. When your friend waves back to you, the motor cortex of your brain will become active as if you had waved again, although you were simply observing and not waving yourself. These neurons 'mirror' what you are observing.

When you see a person perform an action--hailing a cab or sipping on a cappuccino--you simulate these actions automatically among your own neurons as if you were performing the action yourself. The same phenomenon can occur when witnessing emotions like disgust, anger and excitement. Mirror neurons facilitate understanding the movements, thoughts and emotions of other people. 

Mirror neurons allow you to reciprocate the experience of another person.

Mirror neurons absorb culture directly, with each generation teaching the next by social sharing, imitation and observation.
— Dr. Iacoboni, NYTimes
 

My Practice of Empathy

Empathy is like any other skill: practice invites improvement.

As such, you might imagine that empathy is a focal point of medical school education. Yet, learning how to mirror the experience of patients is largely ignored in a curriculum dominated by pharmaceuticals.

The result? Doctors who are more proficient in answering multiple choice questions about drugs than understanding the perspectives and thoughts of their patients. A medical system that favors quantity over quality dissuades the practice of empathy. Empathy requires time.

This oversight of emotional intelligence was a primary motivator behind establishing my medical practice. 

EMPATHY IS CENTRAL TO MY PRACTICE OF MEDICINE.

I take the time needed to understand what my client is thinking and how my client is feeling. Sharing in the experience of my client facilitates the therapeutic alliance: a powerful relationship founded on empathy, collaboration and confidentiality.

ANY DOCTOR CAN WRITE A PRESCRIPTION.

RELATIVELY FEW PRACTICE EMPATHY.

RELATIONSHIPS TRUMP PHARMA.


Resources

Blakeslee S. "Cells that Read Minds" New York Times, Science. 10 Jan 2006. <http://www.nytimes.com/2006/01/10/science/cells-that-read-minds.html>

Cox CL, et. al. "The balance between feeling and knowing: affective and cognitive empathy are reflected in the brain's intrinsic functional dynamics". Aug 2012. Social Cognitive and Affective Neuroscience. 7 (6): 727-37. 

Dapretto M et. al. "Understanding emotions in others: mirror neuron dysfunction in children with autism spectrum disorders". Nature Neuroscience. 2006: 9 (1): 28-31.

Feldman R et. al. "Oxytocin Pathway Genes: Evolutionary Ancient System Impacting on Human Affiliation, Sociality, and Psychopathology." Biol Psychiatry. 1 Feb 2016; 79(3):174-84.

Iacoboni M. "Imitation, Empathy, and Mirror Neurons" Annual Review of Psychology. 10 Jan 2009. Vol 60:1-741.

"Mirror Neurons" Penn State University. 28 June 2016. <https://sites.psu.edu/psych256su16-2/2016/06/28/mirror-neurons/>

Rizzolatti, Giacomo and Laila Craighero. "The mirror-neuron system" Annual Review of Neuroscience. 2004. 27 (1): 169-192.