To elicit the experience of another i. For example, if one comes from a very wealthy or privileged background it may be hard to empathise with another who is homeless or unemployed. Recently, a genre of television has emerged as illustrated by the programmes Filthy Rich and Homeless, Go Back to Where You Came From , and First Contact in which people are handpicked for their lack of contact and often fixed attitudes towards a population e.
Aside from the discomfort of participants, the entertainment value arises from the shift in perspective and increased capacity to empathise that often occurs for participants.
Projecting stereotypes onto others impedes getting to know people as individuals. Various manifestations of mental illness or experiences such as psychosis may pose challenges for people in empathising with that experience. There is obviously an understanding of others that is borne of shared experience.
This is one reason why support groups which bring together people with shared experiences are useful, encouraging participants to develop a sense of universality or an understanding that they are not alone Yalom, A shared experience does not necessarily mean that people can or do empathise with people as individuals. Psychotherapy research confirms that matching an individual with similar traits e. Listening and Attending with Empathy.
Listening to understand requires being fully present with another person in the moment. Health professionals often have agendas which can get in the way of empathic listening. Assessing for symptoms, completing a risk assessment, or undertaking a diagnostic interview may be necessary and be done with sensitivity; however, preoccupation with such tasks can be an obstacle to empathic listening or responding.
Empathic listening is a purposeful, conscious activity which requires practice and one does not learn to do it by practising another skill such as assessment. Where other agendas need to take precedence, it is therapeutic to leave some time for empathic listening and an empathic statement.
It can be worthwhile for psychotherapist and counsellors to consider what might get in the way of them being fully present with another. Questions to consider include:. Some emotions and experiences may feel uncomfortable.
For example, feelings of anger, shame, and remorse may be close to home, and some experiences may be very affecting.
As well as being present, the helper needs to build rapport and trust with the other person. Building understanding requires careful listening. Listening involves more than simply hearing. It involves listening for experiences, feelings, behaviour, gaps, areas of avoidance, and for things that are unsaid. All the while the helper attends, affirms, and responds with curiosity and interest.
Communicating Empathy. Empathy is best employed after listening carefully and when the listener believes they may have some understanding of the core message or experience right now. One does not need to rigidly follow this formula, but an empathic statement will communicate accurately the current emotion and intensity as well as the thoughts or other experiences that are associated with it.
It is important to be tentative rather than dogmatic in expressions of empathy. The statement might be expressed as, or followed by, a question e. The person needs to have the opportunity and feel enabled to correct the helper if they have not been accurate. Acknowledging the feelings may provide an opening to explore in greater depth why those feelings arise.
For the most part, empathy will be a sufficient response but identifying the thoughts and behaviours associated with the feelings may provide opportunities to solve problems interpersonal or practical or address self-defeating thinking as in cognitive behavioural therapy.
Empathy can be used in many ways. In therapy it is used to maintain an alliance, keep the focus on important issues, summarise progress, and validate the other person. In everyday relationships, or in less formal helping relationships, it is called for whenever there are strong emotions or interpersonal difficulties. Expressions of empathy can disarm, reduce conflict, and preserve relationships.
Some people express thoughts or feelings that are disturbing to others, do not appear grounded in shared reality, or display incongruity between their emotional expression and verbal communication. There may be times when the person has little awareness of their own emotional experience and how it relates to their intrapsychic experience.
This sensing and sharing of meaning of which the client may have little awareness is what Egan , p. Such explanations can lead to social distancing Angermeyer et al. Potential helpers may also be fearful or see little point in exploring the depths and origins and nature of the experience. A failure to empathise with people experiencing psychosis is likely to reflect a failure of perspective taking on the part of the helper.
Psychotic experiences include a range of cognitive and perceptual experiences that fall outside the usual sphere of experience.
Such experiences whether transient or more enduring as in those with diagnosed with a psychotic illness such as schizophrenia may be startling, if not terrifying, to the individual Bentall, Often too, people may experience a constellation of symptoms involving perceptions, thoughts, and feelings. Models have been developed with varying degrees of empirical support to explain particular symptoms of psychosis and how to address them.
Most cognitive behavioural models of psychosis e. People who develop paranoid delusions have also been found to have a tendency to blame others for external events, and people who hear voices have been found to have a tendency to attribute internal experiences such as their own thoughts to external sources Alanen et al.
Because of these potential problems it is exceptionally important to gain trust and rapport with the person. Communication needs to be clear, concrete, and unambiguous to avoid misinterpretation. Voices and Other Unusual Perceptual Experiences. Empathising with people experiencing psychosis proceeds in much the same way as with anyone else: with an attitude of curiosity, attentive listening, and asking clarifying questions to understand the experience.
People may need reassurance, encouragement, and kind words to lubricate the conversation and relationship. It can be useful for helpers to ask about the experience, how they are different to other perceptual experiences, how intrusive these experiences are, how dominating, the content of the voices, the frequency of occurrence, and the circumstances in which they are most likely to occur.
An empathic statement can generally follow the empathy formula e. People may also develop beliefs about the identity of voices, the knowledge they possess, and their powers. Because voices are self-generated they unsurprisingly will know all about the individual, including their fears, fantasies, and vulnerabilities. Even if the voice is perceived as a person, it may not be problematic e.
People do have automatic thoughts arising from hallucinatory experiences, which can sometimes develop or reinforce delusional beliefs. These require a more emphatic reinforcement of reality see below. You begin to feel frightened and think that someone is breaking into your house. How can we help you feel safer and less anxious at night?
Delusional Ideas. Delusional ideas have long been particularly challenging to health professionals, and often cause distress to others. Delusions are fixed beliefs that are not amenable to change in light of conflicting evidence American Psychiatric Association, Sometimes delusions can be bizarre, that is, clearly implausible or not comprehensible.
More often than not they do make sense but cannot be reasoned away at least not when people are experiencing a psychotic episode or mood. People hold these beliefs quite tenaciously. The standard textbooks on psychiatry see for example The Diagnostic and Statistical Manual of Mental Disorders [5th ed.
Like all beliefs and experiences, delusions generate emotions in the present and these can be acknowledged empathetically. Often the mood may precede the automatic thoughts and formation of beliefs. For example, people who feel great as in hypomania are likely to develop delusions of grandeur and those who feel depressed are likely to have delusions of guilt. It is these feelings that are real and affecting, and which often further prime people to seek evidence which confirms their thoughts and feelings in a cycle of emotional reasoning.
Seemingly innocuous and unrelated evidence may be rallied to support the belief, which further reinforces the feeling. Thoughts and beliefs may not be grounded in consensual reality, but the feelings associated with those thoughts and beliefs are real and require acknowledgment.
Principles of Responding to Disturbing Beliefs. Psychotherapeutic approaches to address problematic symptoms in psychosis have been developed. However, when the psychosis is acute i. People in this state may also share delusional or unusual ideas in the context of everyday interactions. Figure 1: A model of empathy for people who express disturbing beliefs. Source: Lakeman , p. Like the empathy formula, the advice outlined in Figure 1 should be used judiciously and not applied rigidly.
First, attempt to acknowledge what the person has said. Or it might be framed in a more exploratory way with the view of seeking clarification e. Remember that not every strange utterance is a delusion. Stating that the person is wrong or attempting to bluntly refute evidence for a delusional belief will likely lead to an argument or create a rift in the relationship.
It can be helpful to state what you have perceived e. Be brief and concrete in order to rapidly get to the crux of the matter i. In the case above, if the person has had a test such as CT scan which did not show any pathological signs then state this or some variation e. Empathising with a delusional or odd belief requires the skill of perspective-taking. Consider what it might feel like to hold that belief or have that experience.
It may appear obvious that a person feels a certain way, and this may lead to some other emotion-focused questioning e. Craft an empathic statement linking the belief or experience to the emotion. Clearly, as in most human interactions, this should not be approached in a formulaic way.
Often, the empathic statement is enough and nothing more is needed from the helper; thoughts and feelings do not always demand action. People may need reassurance that they are safe, or further exploration around what might make them feel safe or ameliorate distress. Frequent encouragement and positive comments in their efforts at dealing with their experience will assist in maintaining a good working alliance.
Communicating empathically is a foundational skill for counselling, psychotherapy, and indeed for fostering and maintaining relationships generally. While most people have the capability to communicate empathically, it may not be well developed, or other agendas or issues may impede their capacity to extend this basic gesture to those in great need.
The insights derived from theory and research about psychosis and psychotic states can be very useful in assisting helpers to respond in helpful ways to people. Figure 1. Lexical or Linguistic Alignment A number of studies from the research tradition of conversation analysis CA have shown how talk in informal conversations is linked from turn to turn in a characteristic pattern of turn-taking between the conversational partners.
Vocal Synchrony A number of studies have investigated qualities of the voice in interpersonal interaction. Body Movement, Alignment, and Synchrony The phenomenon of interactive alignment is not limited to verbal behavior. Psychophysiological Synchrony Physiological concordance in interpersonal interaction has been investigated in a number of studies, and the implications for the clinician—patient relations have been suggested.
Summary and Conclusion In this brief review, we have presented evidence that informal human interaction is characterized by mutuality of lexical alignment, reciprocal adjustments, synchrony of movements, and psychophysiological processes.
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Measures and Procedures Therapists interested in completing this study were given access to a link that directed them to an online consent form where participants could indicate their interest in being contacted to set up a phone interview and to complete an online demographic form. Table 1 Several general and typical findings emerged from the data. Cite This Article Shimoda, A.
References Angus, L. Submit a Comment Cancel reply Your email address will not be published. Overcoming Loneliness ». Society for the Advancement of Psychotherapy uses cookies to provide you with a great user experience. By using this website, you agree to the use of cookies on your device. Close Privacy Overview This website uses cookies to improve your experience while you navigate through the website.
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