Empathy is the capacity to recognize and, to some extent, share feelings (such as sadness or happiness) that are being experienced by another sapient or semi-sapient being. Someone may need to have a certain amount of empathy before they are able to feel compassion. The English word was coined in 1909 by E.B. Titchener as an attempt to translate the German word "Einfühlungsvermögen", a new phenomenon explored at the end of 19th century mainly by Theodor Lipps. It was later re-translated into the German language (Germanized) into "Empathie", and is still in use there.[1]
The English word is derived from the Greek word ἐμπάθεια (empatheia), "physical affection, passion, partiality" which comes from ἐν (en), "in, at" + πάθος (pathos), "passion" or "suffering".[2] The term was adapted by Hermann Lotze and Robert Vischer to create the German word Einfühlung ("feeling into"), which was translated by Edward B. Titchener into the English term empathy.[3]
Alexithymia from the Ancient Greek words λέξις (lexis) and θύμος (thumos) modified by an alpha-privative—literally "without words for emotions"—is a term to describe a state of deficiency in understanding, processing, or describing emotions in oneself.[4][5]
Empathy is an ability with many different definitions. They cover a broad spectrum, ranging from caring for other people and having a desire to help them, to experiencing emotions that match another person's emotions, to knowing what the other person is thinking or feeling, to blurring the line between self and other.[6] Below are definitions of empathy:
Since empathy involves understanding the emotional states of other people, the way it is characterized is derivative of the way emotions themselves are characterized. If, for example, emotions are taken to be centrally characterized by bodily feelings, then grasping the bodily feelings of another will be central to empathy. On the other hand, if emotions are more centrally characterized by a combination of beliefs and desires, then grasping these beliefs and desires will be more essential to empathy. The ability to imagine oneself as another person is a sophisticated imaginative process. However, the basic capacity to recognize emotions is probably innate[23] and may be achieved unconsciously. Yet it can be trained and achieved with various degrees of intensity or accuracy.
The human capacity to recognize the bodily feelings of another is related to one's imitative capacities and seems to be grounded in the innate capacity to associate the bodily movements and facial expressions one sees in another with the proprioceptive feelings of producing those corresponding movements or expressions oneself.[24] Humans seem to make the same immediate connection between the tone of voice and other vocal expressions and inner feeling.
Empathy is distinct from sympathy (which includes empathizing with in addition to having a positive regard or non-fleeting concern for the object thereof), pity, and emotional contagion.[25] Sympathy or empathic concern is the feeling of compassion or concern for another, the wish to see them better off or happier. Pity is feeling that another is in trouble and in need of help as they cannot fix their problems themselves, often described as "feeling sorry" for someone. Emotional contagion is when a person (especially an infant or a member of a mob) imitatively "catches" the emotions that others are showing without necessarily recognizing this is happening.[26]
Just as empathy was conceptually distinguished from sympathy, beginning with the early definitions of empathy in the 19th century, the term may be in the process of being distinguished further, this time from "perspective taking". Due both to the conceptual confusions between the emotional and cognitive aspects of empathy and to an emerging sense of the differences in the functional aspects of the two phenomena, more-recent discussions have distinguished between empathy (as the more intuitive emotional aspect) and perspective-taking (as the more cognitive aspect).[27] Some authors, however, see perspective taking as one of the dimensions of empathy.[28]
By the age of two, children normally begin to display the fundamental behaviors of empathy by having an emotional response that corresponds with another person.[29] Even earlier, at one year of age, infants have some rudiments of empathy, in the sense that they understand that, just like their own actions, other people's actions have goals.[30][31][32] Sometimes, toddlers will comfort others or show concern for them at as early an age as two. Also during the second year, toddlers will play games of falsehood or "pretend" in an effort to fool others, and this requires that the child know what others believe before he or she can manipulate those beliefs.[33]
According to researchers at the University of Chicago who used functional magnetic resonance imaging (fMRI), children between the ages of 7 and 12 appear to be naturally inclined to feel empathy for others in pain. Their findings[34] are consistent with previous fMRI studies of pain empathy with adults. The research also found additional aspects of the brain were activated when youngsters saw another person intentionally hurt by another individual, including regions involved in moral reasoning.[35]
Despite being able to show some signs of empathy, such as attempting to comfort a crying baby, from as early as 18 months to two years, most children do not show a fully fledged theory of mind until around the age of four.[36] Theory of mind involves the ability to understand that other people may have beliefs that are different from one's own, and is thought to involve the cognitive component of empathy.[21] Children usually become capable of passing "false belief" tasks, considered to be a test for a theory of mind, around the age of four. Individuals with autism often find using a theory of mind very difficult (e.g. Baron-Cohen, Leslie & Frith, 1988; the Sally-Anne test).
Empathetic maturity is a cognitive structural theory developed at the Yale University School of Nursing and addresses how adults conceive or understand the personhood of patients. The theory, first applied to nurses and since applied to other professions, postulates three levels that have the properties of cognitive structures. The third and highest level is held to be a meta-ethical theory of the moral structure of care. Those adults operating with level-III understanding synthesize systems of justice and care-based ethics.[37]
Research in recent years has focused on possible brain processes underlying the experience of empathy. For instance, functional magnetic resonance imaging (fMRI) has been employed to investigate the functional anatomy of empathy.[38][39] These studies have shown that observing another person's emotional state activates parts of the neuronal network involved in processing that same state in oneself, whether it is disgust,[40] touch,[41][42] or pain.[43][44][45][46] The study of the neural underpinnings of empathy has received increased interest following the target paper published by Preston and Frans de Waal,[47] following the discovery of mirror neurons in monkeys that fire both when the creature watches another perform an action as well as when they themselves perform it. In their paper, they argued that attended perception of the object's state automatically activates neural representations, and that this activation automatically primes or generates the associated autonomic and somatic responses, unless inhibited. This mechanism is similar to the common coding theory between perception and action.
Some psychopaths are able to detect the emotions of others with such a theory of mind and can mimic caring and friendship in a convincing manner, often in an effort to callously exploit others. While some psychopaths can detect what others are feeling, they do not experience any reciprocal emotion or sympathy. However, some research indicates that components of neural circuits involved in empathy may also be dysfunctional in psychopathy.[48]
One characteristic of a person afflicted with narcissistic personality disorder is "lacks empathy: is unwilling to recognize or identify with the feelings and needs of others" in order to maintain a secure emotional distance and protect themselves from vulnerability.[49]
The same ability may underlie schadenfreude and sadism. Recently, an fMRI study conducted by Jean Decety and colleagues at the University of Chicago has demonstrated that youths with aggressive conduct disorder (who have psychopathic tendencies) have a different brain response when confronted with empathy-eliciting stimuli.[50] In the study, researchers compared 16- to 18-year-old boys with aggressive conduct disorder to a control group of adolescent boys with no unusual signs of aggression. The boys with the conduct disorder had exhibited disruptive behavior such as starting a fight, using a weapon and stealing after confronting a victim. The youths were tested with fMRI while looking at video clips in which people endured pain accidentally, such as when a heavy bowl was dropped on their hands, and intentionally, such as when a person stepped on another's foot. Results show that the aggressive youths activated the neural circuits underpinning pain processing to the same extent and, in some cases, even more so than the control participants without conduct disorder. However, aggressive adolescents showed a specific and very strong activation of the amygdala and ventral striatum (an area that responds to feeling rewarded) when watching pain inflicted on others, which suggested that they enjoyed watching pain. Unlike the control group, the youths with conduct disorder did not activate the area of the brain involved in self-regulation and moral reasoning.[50]
Empathic anger is an emotion, a form of empathic distress.[51] Empathic anger is felt in a situation where someone else is being hurt by another person or thing. It is possible to see this form of anger as a pro-social emotion.
Empathic anger has direct effects on both helping and punishing desires. It can be divided to trait and state empathic angers.[52]
The relationship between empathy and anger response towards another person has also been investigated, with dispositional perspective taking found to be significantly negatively related to anger arousal (i.e. the higher a person's perspective taking ability, the less angry they were in response to a provocation). Empathic concern did not, however, significantly predict anger response, and higher personal distress was associated with increased anger.[53]
Empathic distress is feeling the perceived pain of another person, which feeling can be transformed into the empathic anger, feeling of injustice, and guilt. These emotions can be perceived as pro-social, and some say they can be seen as motives for moral behavior.[51]
The interaction between empathy and autism spectrum disorders is a complex and ongoing field of research.
Research suggests that 85% of ASD individuals have alexithymia,[54] which involves not just the inability to verbally express emotions, but specifically the inability to identify emotional states in self or others.[55] According to recent fMRI studies[56] the syndrome of alexithymia, a condition in which an individual is rendered incapable of recognising and articulating emotional arousal in self or others, is responsible for a severe lack of emotional empathy.[56] The lack of empathic attunement inherent to alexithymic states may reduce quality[57] and satisfaction[58] of relationships.
Also common is an impairment in theory of mind (ToM), the ability to model another's world view using either a theory-like analogy between oneself and others, or the ability to simulate pretend mental states and then apply the consequences of these simulations to others.[59] Francesca Happe showed that autistic children who demonstrate a lack of theory of mind (cognitive empathy) lack theory of mind for self as well as for others.[60]
One study found that, relative to typically developing children, high-functioning children with autism showed reduced mirror neuron activity in the brain's inferior frontal gyrus (pars opercularis) while imitating and observing emotional expressions.[61] The authors suggested that their study supports the hypothesis that a dysfunctional mirror neuron system may underlie the social deficits observed in autism. However, this finding has not been replicated by other fMRI studies.[62]
Rogers et al. suggest that one must differentiate between cognitive empathy and affective empathy when regarding people with Asperger syndrome. They suggest that autistic individuals have less ability to ascertain others' feelings, but demonstrate equal empathy when they are aware of others' states of mind. Autistic and AS people actually have a greater response to stress that they witness others experiencing than neurotypical people do.[63]
A common source of confusion in analyzing the interactions between empathy and autism spectrum disorders (ASD) is that the apparent lack of empathy may mask emotional oversensitivity to the feelings of others. People with ASDs may suppress their emotional facility in order to avoid painful feedback. This is cited by Phoebe Caldwell, an author on ASD, who writes:
What is clear is that, while people on the spectrum may not respond easily to external gestures/sounds, they do respond most readily if the initiative they witness is already part of their repertoire. This points to the selective use of incoming information rather than absence of recognition. It would appear that people with autism are actually rather good at recognition and imitation if the action they perceive is one that has meaning and significance for their brains. As regards the failure of empathic response, it would appear that at least some people with autism are oversensitive to the feelings of others rather than immune to them, but cannot handle the painful feed-back that this initiates in the body, and have therefore learnt to suppress this facility.
An apparent lack of empathy may also mask an inability to express empathy to others, as opposed to difficulty feeling it, internally.[64]
Proper empathic engagement helps one to understand and anticipate the behavior of another. Apart from the automatic tendency to recognise the emotions of others, one may also deliberately engage in empathic reasoning. Two general methods have been identified here (e.g. Goldie 2000). A person may simulate 'pretend' versions of the beliefs, desires, character traits and context of the other and see what emotional feelings this leads to. Or, a person may simulate the emotional feeling and then look around for a suitable reason for this to fit.
Some research suggests that people are more able and willing to empathize with those most similar to themselves. In particular, empathy increases with similarities in culture and living conditions. Empathy is more likely to occur between individuals whose interaction is more frequent. (See Levenson and Reuf 1997 and Hoffman 2000: 62). A measure of how well a person can infer the specific content of another person's thoughts and feelings has been developed by William Ickes (1997, 2003). Ickes and his colleagues have developed a video-based method to measure empathic accuracy and have used this method to study the empathic inaccuracy of maritally aggressive and abusive spouses, among other topics.
There are concerns that the empathiser's own emotional background may affect or distort what emotions they perceive in others (e.g. Goleman 1996: p. 104). Empathy is not a process that is likely to deliver certain judgements about the emotional states of others. It is a skill that is gradually developed throughout life, and which improves the more contact we have with the person with whom one empathises. Accordingly, any knowledge gained of the emotions of the other must be revisable in light of further information.
The extent to which a person's emotions are publicly observable, or mutually recognized as such has significant social consequences. Empathic recognition may or may not be welcomed or socially desirable. This is particularly the case where we recognise the emotions that someone has towards us during real time interactions. Based on a metaphorical affinity with touch, philosopher Edith Wyschogrod claims that the proximity entailed by empathy increases the potential vulnerability of either party.[65] The appropriate role of empathy in our dealings with others is highly dependent on the circumstances. For instance, it is claimed that clinicians or caregivers must take care not to be too sensitive to the emotions of others, to over-invest their own emotions, at the risk of draining away their own resourcefulness. Furthermore an awareness of the limitations of empathic accuracy is prudent in a caregiving situation.
Heinz Kohut is the main introducer of the principle of empathy in psychoanalysis. His principle applies to the method of gathering unconscious material. The possibility of not applying the principle is granted in the cure, for instance when you must reckon with another principle, that of reality. Developing skills of empathy is often a central theme in the recovery process for drug addicts.
In evolutionary psychology, attempts at explaining pro-social behavior often mention the presence of empathy in the individual as a possible variable. Although exact motives behind complex social behaviors are difficult to distinguish, the "ability to put oneself in the shoes of another person and experience events and emotions the way that person experienced them" is the definitive factor for truly altruistic behavior according to Batson's empathy-altruism hypothesis. If empathy is not felt, social exchange (what's in it for me?) supersedes pure altruism, but if empathy is felt, an individual will help by actions or by word, regardless of whether it is in their self-interest to do so and even if the costs outweigh potential rewards.[66]
An important target of the method Learning by teaching (LbT) is to train systematically and, in each lesson, teach empathy. Students have to transmit new content to their classmates, so they have to reflect continuously on the mental processes of the other students in the classroom. This way it is possible to develop step-by-step the students' feeling for group reactions and networking.
In increasing number of studies in animal behavior and neuroscience claim that empathy is not restricted to humans, and is in fact as old as the mammals, or perhaps older. Examples include dolphins saving humans from drowning or from shark attacks, and a multitude of behaviors observed in primates, both in captivity and in the wild. (See, for instance, Frans de Waal's The Age of Empathy.) Rodents have been shown to demonstrate empathy for cagemates (but not strangers) in pain.[67] One of the most widely read studies on the evolution of empathy, which discusses a neural perception-action mechanism (PAM), is the one by Stephanie Preston and de Waal ([11]). This review postulates a bottom-up model of empathy that ties together all levels, from state matching to perspective-taking.
Some philosophers (such as Martha Nussbaum) suggest that novel reading cultivates readers' empathy and leads them to exercise better world citizenship. For a critique of this application of the empathy-altruism hypothesis to experiences of narrative empathy, see Keen's Empathy and the Novel (Oxford, 2007). In some works of science fiction and fantasy, empathy is understood to be a paranormal or psychic ability to sense the emotions of others, as opposed to telepathy, which allows one to perceive thoughts as well. A person who has that ability is also called an "empath" or "telepath" in this context. Occasionally these empaths are also able to project their own emotions, or to affect the emotions of others.
Some postmodern historians such as Keith Jenkins in recent years have debated whether or not it is possible to empathise with people from the past. Jenkins argues that empathy only enjoys such a privileged position in the present because it corresponds harmoniously with the dominant Liberal discourse of modern society and can be connected to John Stuart Mill's concept of reciprocal freedom. Jenkins argues the past is a foreign country and as we do not have access to the epistemological conditions of by gone ages we are unable to empathise.[68]
It is impossible to forecast the effect of empathy on the future. A past subject may take part in the present by the so-called historic present. If we watch from a fictitious past, can tell the present with the future tense, as it happens with the trick of the false prophecy. There is no way of telling the present with the means of the past.[69]
In the 2009 book Wired to Care, strategy consultant Dev Patnaik argues that a major flaw in contemporary business practice is a lack of empathy inside large corporations. He states that lacking any sense of empathy, people inside companies struggle to make intuitive decisions and often get fooled into believing they understand their business if they have quantitative research to rely upon. Patnaik claims that the real opportunity for companies doing business in the 21st Century is to create a widely held sense of empathy for customers, pointing to Nike, Harley-Davidson, and IBM as examples of "Open Empathy Organizations". Such institutions, he claims, see new opportunities more quickly than competitors, adapt to change more easily, and create workplaces that offer employees a greater sense of mission in their jobs [4]. In the 2011 book The Empathy Factor, organizational consultant Marie Miyashiro similarly argues the value of bringing empathy to the workplace, and offers Nonviolent Communication as an effective mechanism for achieving this.[70]
In the 2007 book The Ethics of Care and Empathy, philosopher Michael Slote introduces a theory of care-based ethics that is grounded in empathy. His claim is that moral motivation does, and should, stem from a basis of empathic response. He claims that our natural reaction to situations of moral significance are explained by empathy. He explains that the limits and obligations of empathy and in turn morality are natural. These natural obligations include a greater empathic, and moral obligation to family and friends, along with an account of temporal and physical distance. In situations of close temporal and physical distance, and with family or friends, our moral obligation seems stronger to us than with strangers at a distance naturally. Slote explains that this is due to empathy and our natural empathic ties. He further adds that actions are wrong if and only if they reflect or exhibit a deficiency of fully developed empathic concern for others on the part of the agent.[71]
In phenomenology, empathy is used to describe the experience in which one experiences what the other experiences as the experience of experiencing something from the other's viewpoint, without confusion between self and other. This draws on the sense of agency. In the most basic sense, this is the experience of the other's body and, in this sense, it is an experience of "my body over there". In most other respects, however, the experience is modified so that what is experienced is experienced as being the other's experience; in experiencing empathy, what is experienced is not "my" experience, even though I experience it. Empathy is also considered to be the condition of intersubjectivity and, as such, the source of the constitution of objectivity.
Nonviolent Communication places empathy at the heart of its communication process, and treats empathy as a teachable skill, centered on learning to recognize and honor the feelings and universal human needs that are active in oneself and others.
The Roots of Empathy program teaches children empathy through experiences with an infant brought to the classroom.
Research into the measurement of empathy has sought to answer a number of questions: who should be carrying out the measurement? What should pass for empathy and what should be discounted? What unit of measure (UOM) should be adopted and to what degree should each occurrence precisely match that UOM are also key questions that researchers have sought to investigate.
Researchers have approached the measurement of empathy from a number of perspectives.
Behavioural measures normally involve raters assessing the presence or absence of certain either predetermined or ad-hoc behaviours in the subjects they are monitoring. Both verbal and non-verbal behaviours have been captured on video by experimenters such as Truax (1967b).[72] Other experimenters, including Mehrabian and Epstein (1972),[73] have required subjects to comment upon their own feelings and behaviours, or those of other people involved in the experiment, as indirect ways of signalling their level of empathic functioning to the raters.
Physiological responses tend to be captured by elaborate electronic equipment that has been physically connected to the subject's body. Researchers then draw inferences about that person's empathic reactions from the electronic readings produced (e.g. Levenson and Ruef, 1992;[74] Leslie et al., 2004[75]).
Bodily or "somatic" measures can be looked upon as behavioural measures at a micro level. Their focus is upon measuring empathy through facial and other non-verbally expressed reactions in the empathiser. These changes are presumably underpinned by physiological changes brought about by some form of "emotional contagion" or mirroring (e.g. Levenson and Ruef, 1992*; Leslie et al., 2004*). It should be pointed out that these reactions, whilst appearing to reflect the internal emotional state of the empathiser, could also, if the stimulus incident lasted more than the briefest period, be reflecting the results of emotional reactions that are based upon more pieces of thinking through (cognitions) associated with role-taking ("if I were him I would feel...").
Paper-based indices involve one or more of a variety of methods of responding. In some experiments, subjects are required to watch video scenarios (either staged or authentic) and to make written responses which are then assessed for their levels of empathy (e.g. Geher, Warner and Brown, 2001[76]); scenarios are sometimes also depicted in printed form (e.g. Mehrabian and Epstein, 1972[77]). Measures also frequently require subjects to self-report upon their own ability or capacity for empathy, using Likert-style numerical responses to a printed questionnaire that may have been designed to tap into the emotional, cognitive-affective or largely cognitive substrates of empathic functioning. Some questionnaires claim to have been able to tap into both cognitive and emotional substrates (e.g. Davis, 1980[78]). More recent paper-based tools include The Empathy Quotient (EQ) created by Baron-Cohen and Wheelwright[79] which comprises a self report questionnaire consisting of 60 items.
For the very young, picture or puppet-story indices for empathy have been adopted to enable even very young, pre-school subjects to respond without needing to read questions and write answers (e.g. Denham and Couchoud, 1990). Dependent variables (variables that are monitored for any change by the experimenter) for younger subjects have included self reporting on a 7-point smiley face scale and filmed facial reactions (Barnett, 1984).[80]
A certain amount of confusion exists about how to measure empathy. These may be rooted in another problem: deciding what is empathy and what is not. In general, researchers have until now been keen to pin down a singular definition of empathy which would allow them to design a measure to assess its presence in an exchange, in someone's repertoire of behaviours or within them as a latent trait. As a result they have been frequently forced to ignore the richness of the empathic process in favour of capturing surface, explicit self-report or third-party data about whether empathy between two people was present or not. In most cases, instruments have unfortunately only yielded information on whether someone had the potential to demonstrate empathy (Geher et al., 2001)*. Gladstein (1987)[81] summarises the position noting that empathy has been measured from the point of view of the empathiser, the recipient for empathy and the third-party observer. He suggests that since the multiple measures used have produced results that bear little relation to one another, researchers should refrain from making comparisons between scales that are in fact measuring different things. He suggests that researchers should instead stipulate what kind of empathy they are setting out to measure rather than simplistically stating that they are setting out to measure the unitary phenomenon "empathy"; a view more recently endorsed by Duan and Hill (1996).[82]
In the field of medicine, a measurement tool for carers is the Jefferson Scale of Physician Empathy, Health Professional Version (JSPE-HP).[83] At least one study using this tool with health sciences' students has found that levels of empathy are greater amogst females than males, and also are greater amongst older students than younger students.[84]
The issue of gender differences in empathy is quite controversial. It is often believed that females are more empathic than males. Evidence for gender differences in empathy are important for self report questionnaires of empathy in which it is obvious what was being indexed (e.g., impact of social desirability and gender stereotypes) but are smaller or nonexistent for other types of indexes that are less self-evident with regard to their purpose.[85] On average female subjects score higher than males on the Empathy Quotient (EQ), while males tend to score higher on the Systemizing Quotient (SQ).
Both males and females with Autistic Spectrum Disorders usually score higher on the SQ (Baron-Cohen, 2003).[21] However, a series of recent studies, using a variety of neurophysiological measures, including MEG,[86] spinal reflex excitability,[87] and electroencephalography[88][89] have documented the presence of a gender difference in the human mirror neuron system, with female participants exhibiting stronger motor resonance than male participants. In addition, these aforementioned studies found that female participants scored higher on empathy self report dispositional measures and that these measures positively correlated with the physiological response. However, other studies show that women do not possess greater empathic abilities than men, and perceived gender differences are the result of motivational differences.[90][91] Using fMRI, neuroscientist Tania Singer showed that empathy-related neural responses are significantly lower in males when observing an “unfair” person experiencing pain.[92]
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