Clever H
Autumn 2014 - The therapeutic relationship

Making Sense of Empathy – An Attempt

 Making Sense of Empathy – An Attempt




Carl Rogers defines empathy as perception of “the internal frame of reference of another with accuracy, and with the emotional components and meanings which pertain thereto, as if one were the other person, but without ever losing the ‘as if’ condition” [1, (p.205)].



Yet, the definitions of the term ’empathy’ are manifold and in their explanatory content inconclusive. This is largely due to the fact that empathy is more of an “interactional” experience, than a stable definitive entity [2, (p.141)]. Its definition varies depending on the context within which this element is considered [3]. The concept of empathy is deeply rooted in psychotherapy, and in particular elemental to the helping relationship in client-centred therapy [2]. The impact of empathy in the therapeutic sphere, as a healing element, is long accepted and acknowledged as a condition for promoting change in a patient, yet, its creation and expression are aspects not yet fully understood [2].



There are subjective and objective aspects of empathy [4]. It is either found to be the “communication of the therapists experience”, an element born from the patient-practitioner interaction (p.142), or it is a therapeutic tool, a communicative agent, provided in the consultation by the therapist [2]. Subjectively, empathy is an experience of the practitioner, which permits him to sense the patient in the frame of references that structure his existence [2, 3], to feel into his state [1] and grasp him “experientially” [4, (p. 72)]. How this occurs is yet unexplained, but it involves verbal and non-verbal cues [1, 3], and the practitioners understanding of the self and his very own experiences [1, 4]. It expresses the unconscious perception, the intuitive reaction [1, 4]. It is a state that the therapist provides for the patient, that in the therapeutic union will enable the patient to become empowered and grow. As a subjective experience, it remains an inherent expression of the practitioner [2].



As a tool, a communicative skill however, empathy may be seen as a “behavioural response” of the therapist (p.144). This raises the question of what and how much the patient perceives as being empathic in the communication from the practitioner. As such “empathy is a static attribute that can be transferred” (p.144) from the therapist to the patient. Yet is this deep enough a definition? Verbal and non-verbal communication may well be comprehended for their words and universal meaning, but the perception of the experiential nature of what is communicated, is a sensation not akin to those routes of communication [2]. This makes empathy an expression born out of the patient-practitioner dynamic.



With the therapist as the origin of empathy, leaving the patient uninvolved in its expression, the person-centred approach founded and propagated by Carl Rogers, describes empathy as a core condition to the states of being of the practitioner in the consultation. A patient met in the therapeutic union by such behavioural expressions, would in it find the space to develop [2]. Therefore, empathy is a qualitative expression of the practitioner-self, that is created in the patient-practitioner union.



Empathy is idiosyncratic, experienced and expressed differently by every practitioner. Likewise, is the perception and comprehension of empathy, in the patient, dependant on the individual [1, 2]. Therefore, no objective element in the therapeutic relationship can be inherently empathic. Consequently, the empathic experience is a subjective sensation supported by the objective elements of the patient-practitioner alliance.



Empathy is therefore not just a tool grounded in conscious expression, an action that a practitioner can promote. It is a sensation communication of the practitioner to the patient, an interaction created with the patient [2]. If empathy cannot be achieved, growth in the patient cannot be facilitated [3, 4], and research has shown that an empathic presence in the therapeutic encounter raises patients preparedness to share their story, “increases their self-efficacy”, and ultimately promotes their recovery [5. (p.1100)].






[1] McMillan, M. (1997) The Experiencing of Empathy: what is involved in achieving the ‘as if’ condition? Counselling Vol.8, No.3, pp.205-209




[2] Myers, S. (1999) Empathy: Is that what I hear you say? The Person-Centered Journal Vol. 6, No.2, pp.141-152



[3] Bhautesh Dinesh Jani, D. B., Blane, D. & Mercer, S. (2012)The Role of Empathy in Therapy and the Physician-Patient Relationship Forsch Komplementmed Vol. 19, pp.252–257 [online] Last accessed July, 2013 at DOI: 10.1159/000342998



[4] Schuster, R. (1979) Empathy and Mindfulness J. Humanistic Psychology Vol. 19, No. 1, pp.71-76



[5] Larson, E. & Yao, X. (2005) Clinical empathy as emotional labour in the patient-practitioner relationship JAMA Vol.293, No.9. pp.1100-1106 [online] Last accessed March 2007 at URL:





About the Author:

Profile picUta Mittelstadt, BSc & MSc in homeopathic medicine: I am a homeopath, an artist, a writer and a vegegan, a traveller, and adventurer. I’m a crab born in June. I am passionate about homeopathy. I have a BSc and MSc in homeopathic medicine. I love to investigate and write about my findings, and I blog at Clever Homeopathy



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