Some intriguing quotes - Empathy For Health

J.Decety, W.Ickes: “After decades as the cultivated interest of scholars in philosophy and in clinical and developmental psychology, empathy research is suddenly everywhere! Seemingly overnight it has blossomed into a vibrant, multidisciplinary field of study and has crossed the boundaries of clinical and developmental psychology to plant its roots in the soil of personality and social psychology, mainstream cognitive psychology, and cognitive-affective neuroscience.” [Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusetts, 2011, p. VII]
D.Howe: “One of the earliest appearances of the word Einfühlung, later translated as empathy, was in 1846. Philosopher Robert Vischer used Einfühlung to discuss the pleasure we experience when we contemplate a work of art (e.g. Vischer 1873/1994). The word represented an attempt to describe our ability to get 'inside' a work of beauty by, for example, projecting ourselves and our feelings 'into' a painting, a sculpture, a piece of music, even the beauty of nature itself.” [D.Howe Empathy - What it is and why it matters. Palgrave Macmillan 2013:240, p.6]
M. Dekeyser, R. Elliott, M. Leijssen: “Bohart and colleagues (2002) conducted a meta-analysis of the available research relating empathy to psychotherapy outcome. Based on an exhaustive search of the literature, these authors located 47 studies, including 190 separate test of the empathy-outcome association, and a total of 3026 clients. Typically, these studies involved mixed, eclectic, or unspecified types of individual treatment, targeting affective and anxiety disorders… Overall, empathy accounts for more outcome variance than does the specific intervention used.” [Mathias Dekeyser, Robert Elliott, Mia Leijssen “Empathy in psychotherapy: dialogue and embodied understanding” in Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusett, 2011, p.119]
C. Rogers: “The more the therapist is perceived by the client as being genuine, as having empathic understanding and an unconditional regard for him, the greater will be the degree of constructive personality change in the client.” [in Hart, J.T. and Tomlinson, T.M. (eds.)(1970). New Directions in Client-Centered Therapy, Boston: Houghton Mifflin, p.194]
Th.Lipps, describing the process of Einfühlung : “When I see a gesture, there exists within me a tendency to experience in myself the affect that naturally arises from that gesture. And when there is no obstacle, the tendency is realized.” [Theodor Lipps 1907, quoted in "Theodor Lipps and the shift from 'sympathy' to 'empathy'." G.Jahoda, Journal of the History of the Behavioral Sciences, 2005:41, p.155-159]
S.G.Toukmanian: “It is important to recognise that there is a difference between a therapist’s experience of empathy and acceptance and the actual articulation or communication of the complexity of this experience to the client. Experiencing is both an intrapersonal as well as a relational phenomenon, while the articulation of experience is an interpersonal and co-constructive process.” [in Gill Wyatt and Pete Sanders (eds) Contact and Perception (Rogers Therapeutic Conditions Evolution Theory & Practice). PCCS Books, 2002: 311 , p.126]
P.F.Schmid: “... psychotherapy as the art of not-knowing, i.e. the interesting and challenging part is the unknown and not-yet-understood. From a personal perspective to be empathic generally means to bridge the gap between differences, between persons – without removing the differences and without ignoring them.“ [in Gill Wyatt and Pete Sanders (eds) Contact and Perception (Rogers Therapeutic Conditions Evolution Theory & Practice). PCCS Books, 2002: 311, p.199]
C.Keysers: "Neuroscience shows us that we connect not only through our thoughts, or because we make an effort to conceive ourselves enduring all the same torments that we enter as it were into [someone else’s] body, but through our brains’ proclivity to simply and spontaneously link the actions and emotions together, without requiring the intervention of conscious effort. The brain is hard wired to turn us into highly social and empathic animals." [Christian Keysers The Empathic Brain. Social Brain Press, 2011: 248, p.117]
C.Keysers: "...when you recognize that we perceive the actions of others in the same regions that we use to program our own actions and that we also understand the emotions of others in the emotional areas of our brain, you can conclude that, instead of being a peculiar property of individual brain regions, mirroring is a rather general principle of brain function… The exact brain area activated changes from motor areas for actions, emotional areas for emotions, and somatosensory areas for sensations, but the principle remains the same." [Christian Keysers The Empathic Brain. Social Brain Press, 2011: 248, p.122]
D.A. Matthews et al: Moments of understanding and connectedness in clinical encounters are “often marked by physiological reactions such as gooseflesh or a chill, by an immediacy of awareness of the patient’s situation (as if experiencing it from inside the patient’s world), by a sense of being part of a larger whole; and by a lingering feeling of joy, peacefulness, or awe. Such moments seem to be therapeutic for the patient and the clinician alike.” [Matthews, D.A., Suchman, A.L., Branch, W.T. Making “connexions”: Enhancing the therapeutic potential of patient-clinician relationships. Annals of Internal Medicine 1993, 118, 973-977, p.973]
Collier V.U. e al: “61% of residents in American residency training programs believed that they had become more cynical during their medical education.” [Collier, V.U., MaCue, J.D., Markus, A., Smith, L. Stress in medical residency: status quo after a decade or reform? Annals of Internal Medicine 2002, 136, 384-390].
H.Mohammadreza: “An abundance of evidence suggests that empathy in physician-patient relationships not only contributes to patients’ satisfaction with their healthcare providers and adherence to the providers’ advice but also leads to adequate disclosure of problems, all of which can have a significant impact on patient outcomes.” [H.Mohammadreza Empathy in Patient Care. Springer Science, 2007:293, p.167]
R.Philipp: “Doctors are failing in matters of empathy and intuition, perhaps because of the present emphasis in diagnosis and therapy for 'evidence-based' medicine, based on measurable experience... Medicine in contemporary society may be failing because doctors do not listen to pleadings behind the spoken word.” [Philipp R, Philipp E, Thorne P. The importance of intuition in the occupational medicine clinical consultation. Occup Med (Lond). 1999 Jan;49(1):37-41.]
D.Howe: “Empathy not only entails knowing what a person is feeling and feeling what a person is feeling, but also communicating, perhaps with compassion, the recognition and understanding of the other's emotional experience.” [D.Howe Empathy - What it is and why it matters. Palgrave Macmillan 2013:240, p.14]
D.Howe: “Empathizers say neither too much nor too little, and what they do say and communicate contains an awareness of other people's feelings, perceptions and attitudes. There is much checking of what others think and feel. Other people are invited to express their views... And if we achieve a strong sense of the other's feelings, they, in turn, 'feel felt'. There is resonance. There is attunement. There is empathy.” [D.Howe Empathy - What it is and why it matters. Palgrave Macmillan 2013:240, p.15]
D.Howe: “The fact that so many disciplines are waxing lyrical about empathy and recognizing its importance in the conduct of human affairs is in itself revealing. The common thread that links all these disciplinary interests is the idea that empathic minds foster cooperation, collaboration and civility... Advanced empathy seems to mark out and define our species' current success.” [D.Howe Empathy - What it is and why it matters. Palgrave Macmillan 2013:240, p.15+30]
D.Howe: “One of the most important experiences reported by clients and patients is feeling understood. Only when clients feel that the therapist or counsellor, doctor or clinician is genuinely interested in them and their condition (and is not evaluating them) are they prepared to engage.” [D.Howe Empathy - What it is and why it matters. Palgrave Macmillan 2013:240, p.110]
S.R.Covey: “When you listen with empathy to another person, you give that person psychological air. And after that vital need is met, you can then focus on influencing or problem solving. This need for psychological air impacts communication in every area of life... Empathic listening is also risky. It takes a great deal of security to go into a deep listening experience because you open yourself up to be influenced. You become vulnerable. It's a paradox, in a sense, because in order to have influence, you have to be influenced. That means you have to really understand.” [S.R.Covey The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change. Simon & Schuster 2004:373, p.241+243]
S.R.Covey: “We need to have the skills [of empathic listening]. But let me reiterate that the skills will not be effective unless they come from a sincere desire to understand. People resent any attempt to manipulate them.” [S.R.Covey The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change. Simon & Schuster 2004:373, p.252]
Modeling empathy, according to Lide, the therapist “must experience what the client is feeling (identification), feel the client's experiences as if it were his own (incorporation), evoke those life experiences of his own that may aid in understanding his client's experiences (reverberation), and engage in objective analysis using methods of reason (detachment).” [P.Lide Dynamic mental representation: An analysis of the empathic process. Social Casework, March 1966, p.148]
S&N Thompson: “… the importance of empathy, not sympathy. She made me realize that I had allowed myself to slip into a sympathetic way of working rather than an empathetic way. It was a tough job making the transition, but I recognized that I had to - I couldn't go on the way I was; it would have done me a lot of harm and would also have meant that I was less help to my clients.” [S.Thompson and N.Thompson, The critically reflective practitioner. Houndmills: Palgrave Macmillan 2008 p. 41]
One patient: “I don't like to feel safe (or cared for) because then I let my guard down - that's dangerous.” [G.Liotti, P.Gilbert Mentalizing, motivation, and social mentalities: Theoretical considerations and implications for psychotherapy Psychology and Psychotherapy: Theory, Research and Practice, 2011, 84 p. 20]
D.Howe: “If those in the helping profession are to maintain an empathic stance and uphold a therapeutic alliance, they, too, must feel understood and supported. Like their clients, they must also feel safe enough to go exploring the rough terrains and troubled waters of other people's minds.” [D.Howe Empathy - What it is and why it matters. Palgrave Macmillan 2013:240, p.134]
W. Ickes : “Empathically accurate perceivers are those who are consistently good at ‘reading’ other people’s thoughts and feelings. All else being equal, they are likely to be the most tactful advisors, the most diplomatic officials, the most effective negotiators, the most electable politicians, the most productive salespersons, the most successful teachers, and the most insightful therapists.” [W. Ickes Introduction. In W.Ickes (ed.) Empathic accuracy. New York: Guilford Press, 1997, p.234]
F. De Waal : “Being in tune with others, coordinating activities, and caring for those in need isn't restricted to our species. Human empathy has the backing of a long evolutionary history.” [Frans De Waal The Age of Empathy: Nature's Lessons for a Kinder Society. Souvenir Press Ltd, 2011, p X]
A. Smith : “How selfish soever man may be supposed, there are evidently some principles in his nature, which interest him in the fortune of others, and render their happiness necessary to him, though he derives nothing from it except the pleasure of seeing it.” [Adam Smith, at the opening of 'The Theory of Moral Sentiments']
F. De Waal : “We can’t exactly call empathy ‘selfish,’ because a perfectly selfish attitude would simply ignore someone else’s emotions. Yet it doesn’t seem appropriate either to call empathy ‘unselfish’ if it is one’s own emotional state that prompts action.” [Frans De Waal The Age of Empathy: Nature's Lessons for a Kinder Society. Souvenir Press Ltd, 2011, p.75]
F. De Waal : “One male lost his life when he waded into water to reach an infant who had been dropped by an incompetent mother... Such heroism is common in chimpanzee social life.” [Frans De Waal The Age of Empathy: Nature's Lessons for a Kinder Society. Souvenir Press Ltd, 2011, p.106]
F. De Waal : “Empathy engages brain areas that are more than a hundred million years old. The capacity arose long ago with motor mimicry and emotional contagion, after which evolution added layer after layer, until our ancestors not only felt what others felt, but understood what others might want or need. The full capacity seems put together like a Russian doll.” [Frans De Waal The Age of Empathy: Nature's Lessons for a Kinder Society. Souvenir Press Ltd, 2011, p.208]
F. De Waal : “What kind of life would we have if we shared in every form of suffering in the world? Empathy needs both a filter that makes us select what we react to, and a turn-off switch.” [Frans De Waal The Age of Empathy: Nature's Lessons for a Kinder Society. Souvenir Press Ltd, 2011, p.213]
S. Gerhardt : “Interestingly, the anterior cingulate is activated not only when we are aware of our own feelings, but also when we are thinking about other people’s states of mind, showing how closely linked the two forms of awareness are.” [Sue Gerhardt The Selfish Society: How We All Forgot to Love One Another and Made Money Instead. Simon & Schuster Ltd, 2011, p. 76]
S. Gerhardt : “Strict parenting tends to produce moral behavior which is merely compliant or generated by fear. In a relationship lacking of mutual trust and confidence, the child does not learn to identify with the parent’s perspective, or to feel spontaneous concern for others. In the absence of an empathic response to others, morality can only be imposed from the outside, rather than coming from the inside.” [Sue Gerhardt The Selfish Society: How We All Forgot to Love One Another and Made Money Instead. Simon & Schuster Ltd, 2011, p. 156-7]
J.Decety, W.Ickes: “The capacity for empathy in humans and their progenitor species developed over millions of years of evolutionary history, in ways that are only now becoming clear. Although it is impossible to travel back in time and observe these developments directly, the evidence for them is available in the neuroanatomical continuities and differences that can be observed across the phylogenetic spectrum.” [Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusetts, 2011, p. VII]
C.D.Batson : “It would simplify matters if empathy referred to a single object and if everyone agreed on what that object was. Unfortunately, as with many psychological terms, this is not the case… At least eight different psychological states you might experience in this interchange correspond to distinct concepts of empathy… The best one can do is recognize the different phenomena, make clear the labelling scheme one is adopting, and use that scheme consistently.” [C.Daniel Batson "These things called empathy: eight related but distinct phenomena." in Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusett, 2011, p.4+8]
C.D. Batson : "For those whose profession commits them to helping others in need (such as clinicians, counselors, and physicians), accurate perception of the need – diagnosis – is of paramount importance because one is not likely to address a need effectively unless one recognizes it. Moreover, high emotional arousal, including arousal of other-oriented emotions, may interfere with one’s ability to help effectively (MacLean, 1967). Accordingly, within the helping professions, emphasis is often placed on accurate knowledge of the client’s or patient’s internal state [cognitive empathy], not on other-oriented feelings [pity, sympathy].” [C.Daniel Batson "These things called empathy: eight related but distinct phenomena." in Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusett, 2011, p.11]
E.Hatfield, R.L.Rapson, Y.L.Li: “Most clinical and counselling psychologists agree that true empathy requires three distinct skills: the ability to share the other person’s feelings, the cognitive ability to intuit what another person is feeling, and a ‘socially beneficial’ intention to respond compassionately to that person’s distress.” [Elaine Hatfield, Richard L. Rapson, Yen-Chi L. Le "Emotional contagion and empathy" in Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusett, 2011, p.19]
E.Hatfield, R.L.Rapson, Y.L.Li : “People seem to be capable of mimicking others’ facial, vocal, and postural expressions with stunning rapidity. As a consequence, they are able to feel themselves into those other emotional lives to a surprising extent. And yet, puzzlingly, most people seem oblivious to the importance of mimicry and synchrony in social encounters. They seem unaware of how swiftly and how completely they are able to track the expressive behaviors and emotions of others.” [Elaine Hatfield, Richard L. Rapson, Yen-Chi L. Le "Emotional contagion and empathy" in Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusett, 2011, p.26]
J.Piaget : “Every beginning instructor discovers sooner or later that his first lectures were incomprehensible because he was talking to himself, so to say, mindful only of his own point of view. He realizes only gradually and with difficulty that it is not easy to place oneself in the shoes of students who do not know what he knows about the subject matter of his course.” [Jean Piaget 1962, quoted in "Illusions of comprehension, competency, and remembering." in Jacoby, Bjork, & Kelly in D.Druckman & R.A.Bjork (eds), Learning, remebering, believing: enhancing human performance. Washington DC: National Academy Press, 1994, p. 63]
R.B. van Baaren, J. Decety, A. Dijksterhuis, A. van der Leij, M. L. van Leeuwen: “Developmental research indicates that we are hardwired for imitation with our conspecifics, and that such a mechanism is the stepping-stone to intersubjectivity. Finally, recent research also shows that there is a correlation between a person’s empathy and his or her tendency to imitate.” [Rick.B. van Baaren, Jean. Decety, Ap. Dijksterhuis, Andries. van der Leij, Matthijs. L. van Leeuwen "Being imitated: consequences of nonconsciously showing empathy" in Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusett, 2011, p.33]
R.S.Nickerson, S.F.Butler, M.Carlin: “What does it mean to take the perspective of another person? As philosophers have been pointing out for centuries, there is no way that person A can verify that the experience he has when he sees red is the same experience that person B has when she sees red… Nevertheless, each of us thinks he or she can understand another’s state of mind when the other says he or she is happy, sad, in pain, contented, confused, euphoric, or worried.” [Rayond S. Nickerson, Sucsan F. Butler, Michael Carlin "Empathy in Knowledge projection" in Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusett, 2011, p.51]
R.S.Nickerson, S.F.Butler, M.Carlin : “Much of the common ground that plays a critical role in communication – whether by shaping utterances, as the audience-design hypothesis contends, or by correcting errors of comprehension, as the monitoring-and-adjustment hypothesis claims – is tacit and probably not even consciously recognized as instrumental unless brought to one’s attention.” [Rayond S. Nickerson, Sucsan F. Butler, Michael Carlin "Empathy in Knowledge projection" in Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusett, 2011, p.52]
J. Decety, P.L.Jackson : “Empathy… necessitates some level of emotion regulation to manage and optimize intersubjective transactions between self and other. Indeed, the emotional state generated by the perception of the other’s state or situation needs regulation and control for the experience of empathy. Without such control, the mere activation of the shared representation, including the associated autonomic and somatic responses, would lead to emotional contagion or emotional distress.” [J. Decety, P.L.Jackson The functional architecture of human empathy. Behavioral and cognitive neuroscience revies. 2004:3, p. 87]
N. Eisenberg, N. D.Eggum: “A secure attachment and sensitive, supportive parenting have been associated with children's higher levels of self-regulation, understanding of others' emotions and internal states, and empathy/sympathy.” [Nancy Eisenberg, Natalie D.Eggum "Empathic responding: sympathy and personal distress" in Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusett, 2011, p.79]
M. Dekeyser, R. Elliott, M. Leijssen: “Peters (2005) argues that readiness for interaction is an inborn faculty that remains functional throughout life in all populations, including infants with an autistic spectrum disorder, psychotic adults and older persons with dementia. This view implies that an empathic process can be established with almost any client or patient, but only if the therapist can tune into the person’s current, sometimes strange or frightening experiences and physical modes of expression.” [Mathias Dekeyser, Robert Elliott, Mia Leijssen “Empathy in psychotherapy: dialogue and embodied understanding” in Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusett, 2011, p.116]
M. Dekeyser, R. Elliott, M. Leijssen: “…understanding of empathy as essentially an imaginative, bodily experience rather than as a conceptual process. A wide range of language has been used to describe this experience, with five bodily metaphors capturing the major aspects: letting go; resonating; moving toward or into; discovering or discerning; and grasping or taking hold.” [Mathias Dekeyser, Robert Elliott, Mia Leijssen “Empathy in psychotherapy: dialogue and embodied understanding” in Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusett, 2011, p.117]
M. Dekeyser, R. Elliott, M. Leijssen: “…having entered into the client’s world, the therapist then latches on to what is central, critical, alive, or poignant, sometimes with a sudden sense of insight into the other. The impression is one of taking some element of the client’s experience inside oneself, thus making it part of oneself. On this basis, therapists will try to express what they think is important to the client,, or they will respond in a way that makes sense from what they comprehend. When clients’ responses are welcomed as continuous feedback for the process of attunement, empathic accuracy will increase.” [Mathias Dekeyser, Robert Elliott, Mia Leijssen “Empathy in psychotherapy: dialogue and embodied understanding” in Jean Decety, William Ickes (eds) The Social Neuroscience of Empathy. The MIT Press, Cambridge Massachusett, 2011, p.118]
C. Rogers: “When I am at my best, as a group facilitator or as a therapist, I discover another characteristic. I find that when I am closest to my inner, intuitive self, when I am somehow in touch with the unknown in me, when perhaps I am in a slightly altered state of consciousness, then whatever I do seems to be full of healing, Then, simply my presence is releasing and helpful to the other.” [Carl Ransom Rogers, A way of Being. Houghton Mifflin, Boston, 1980, p.129]
C. Rogers: “I let myself go into the immediacy of the relationship where it is my total organism which takes over and is sensitive to the relationship, not simply my consciousness. I am not consciously responding in a planful or analytic way, but simply in an unreflective way to the other individual, my reaction being based (but not consciously) on my total organismic sensitivity to this other person. I live the relationship on this basis. May 1958 Contributions to existential therapy.” [Carl Ransom Rogers, On Becoming a Person. London, Constable, 1961, p.202]
C.D. Batson: “The most plausible account is that empathic concern evolved as part of the parental instinct among higher mammals, especially humans... If mammalian parents were not interested in the welfare of their very vulnerable progeny, these species would quickly die out.” [C.Daniel. Batson "The empathy-altruism hypothesis: issues and implications" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.46]
C.D. Batson: “The induction of empathic concern is often an explicit component of techniques used in conflict-resolution workshops. Participants in these workshops are encouraged to express their feelings, their hopes and fears, and to imagine the thoughts and feelings of those on the other side of the conflict.[C.Daniel. Batson "The empathy-altruism hypothesis: issues and implications" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.48]
S. Echols: “Batson ultimately argues that research on empathy addresses two separate questions: (1) How does one come to understand another person’s unique affective state? This refers to empathic understanding. And (2) what guides the development of concern and a motivation to respond with care for another individual’s plight? This refers to empathic concern.” [S.Echols, J.Correll "It's more than skin deep: empathy and helping behavior across social groups" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.56]
K.L.Lewis, S.D.Hodges: “Several scholars contrast between two forms of empathy: a basic form where perceivers (perhaps automatically) detect and decode cues such as facial expressions to understand another’s emotions and a more advanced form that requires complex cognitive abilities to understand another’s behavior, thought processes, or intentions. Recent research from our lab suggests that these basic and advanced empathic abilities may be separate abilities, orthogonal to one another… One explanation for the surprising lack of correlation between these two types of empathy may be that they draw on different skill sets. Whereas basic empathy is a ‘bottom-up’ strategy that requires a perceiver to detect and decode cues that are directly available in an interpersonal situation, advanced empathy may instead rely less on decoding cues in the immediate interaction and more on ‘top-down’ strategies that require the use of mental representations that exist in the perceiver’s own mind.” [Karyn L.Lewis, Sara D.Hodges "Empathy is not always as personal as you may think: the use of stereotypes in empathic accuracy" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.73-74]
F.B.M. de Waal: “Emotional connectedness in humans is so common, starts so early in life, shows neural and physiological correlates as well as a genetic substrate, that it would be strange indeed if no continuity with other species existed. Emotional responses to displays of emotion in others are in fact so commonplace in animals that Darwin [1871] already noted that “many animals certainly sympathize with each other’s distress or danger.” [Frans B.M. de Waal "Empathy in primates and other mammals" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.89]
F.B.M. de Waal: “On bad days when her arthritis is acting up she has great trouble walking and climbing. But other females help her out. For example, Peony is huffing and puffing to get up into the climbing frame in which several chimpanzees have gathered for a grooming session. An unrelated younger female moves behind her, places both hands on her ample behind and pushes her up with quite a bit of effort until Peony joins the rest.” [Frans B.M. de Waal "Empathy in primates and other mammals" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.97]
F.B.M. de Waal: “Instead of driving wedges between, let us say, emotional contagion and empathy, compassion and sympathy, or automatic and deliberated empathy, all of these capacities are connected, I believe. None of them could probably exist without the others. For example, what would empathy be without emotional engagement? Psychopaths may be capable of perspective-taking that superficially looks like empathy, but given their lack of emotional investment they cannot truly be called empathetic… This reflects a typically biological way of thinking, stressing the unity behind a phenomenon and the realization that evolution rarely throws out anything. It rarely replaces one trait with another. Traits are transformed, modified, co-opted for other functions, or ‘tweaked’ in another direction in what Darwin called ‘descent with modification.’” [Frans B.M. de Waal "Empathy in primates and other mammals" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.100]
S.Light, C.Zahn-Waxler: “[Beside empathic concern,] two other forms of empathy exist. Empathic happiness occurs when one vicariously experiences pleasure and goodwill in response to another’s positive emotion. Empathic cheerfulness is seen when one exudes positive emotion and goodwill toward someone in distress. This can alleviate that person’s distress by reducing negative emotions, possibly shifting their mood by catalyzing a positive emotional state within them.” [Sharee Light, Carolyn Zahn-Waxler "Nature and forms of empathy in the first years of life" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.110]
S.Light, C.Zahn-Waxler: “Neural connections between brain areas involving emotion and foresight made the expression of a broader sense of responsibility possible: that is, parental concern for the young generalized to other members of the species through the higher reaches of the brain. Our ability to share affective states thus is based on phylogenetically old structures that develop very early in ontogeny in humans.” [Sharee Light, Carolyn Zahn-Waxler "Nature and forms of empathy in the first years of life" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.116]
S.Light, C.Zahn-Waxler: “Bottom-up and top-down processing contribute to our capacity to resonate with each other emotionally and experience empathy. Bottom-up processes allow for the rapid processing of an affective signal, such as someone in pain; and top-down processes allow for the perceiver’s intentions, motivations, and feelings to be attached to the feeling state initiated by the bottom-up process.” [Sharee Light, Carolyn Zahn-Waxler "Nature and forms of empathy in the first years of life" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.116]
S.Light, C.Zahn-Waxler: “Oxytocin, a peptide that is both a hormone and a neurotransmitter, has broad influences on social and emotional processing throughout the body and brain. Oxytocin is implicated in social bonding and empathy in adults… Oxytocin levels are reduced in children who experience social deprivation and neglect… Intranasal oxytocin administration acted as an empathogen for emotional empathy but not cognitive empathy in adult men.” [Sharee Light, Carolyn Zahn-Waxler "Nature and forms of empathy in the first years of life" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.118]
J.Halpern: “Medical practice is a particularly important yet challenging setting for empathy. Empathy is necessary because patients may be reluctant to discuss, or may not be able to identify, their most concerning problems, so that discerning their needs requires excellent listening skills. Empathy is also crucial because the biggest obstacle to effective medical care is patients not adhering to treatment recommendations, and the biggest determinant of adherence is trust in the physician. Empathy plays a crucial role in establishing that trust.” [Jodi Halpern "Clinical empathy in medical care" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.229]
J.Halpern: “Medical graduations to this day continue to honor Sir William Osler, father of medical residency training, and quote his essay ‘Aequanimitas,’ written in 1904, as an inspiration to new physicians. He writes that the doctor should be so emotionally neutral that “his blood vessels don’t constrict and his heart rate remains steady when he sees terrible sights.”… 1963, Rene Fox and Howard Lief write their classic essay ‘Training for Detached Concern.’ They describe how medical students equate the detachment required to dissect a cadaver to the stance they need to listen empathically without becoming emotionally involved. The seeming inconsistency – in which it is detachment from all human emotion that makes one especially skilled at empathy – hints at the unconscious, wishful thinking motivating the ideal of detached concern.” [Jodi Halpern "Clinical empathy in medical care" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.230]
J.Halpern: “…Society for General Internal Medicine’s statement that: “Empathy is the act of correctly acknowledging the emotional state of another without experiencing that state oneself.”[Jodi Halpern "Clinical empathy in medical care" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.230]
J.Halpern: “Many research studies and medical educators presume that the cognitive aim of clinical empathy is to help the physician label the patient’s emotion type correctly – recognizing for example, when a patient is angry or worried. However, I would argue that this labelling is only a very beginning step. It is often fairly obvious that a patient is angry or sad, but what needs to be understood is what, in particular, his anger or sadness is about.” [Jodi Halpern "Clinical empathy in medical care" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.232]
J.Halpern: “The cognitive aims of medical care are, of course, much broader than understanding how a patient feels. The overarching cognitive aims include making an accurate diagnosis, and not missing important needs that can be addressed to help the patient. The pathway to meeting these goals is to take a ‘good’ history – a history that tracks important needs and leads to correct diagnosis. It turns out that listening in a non-verbally attuned way, which is another aspect of clinical empathy, plays a crucial role in taking a good history.” [Jodi Halpern "Clinical empathy in medical care" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.234]
J.Halpern: “It can be tempting for the doctor to imagine herself in a patient’s shoes and think that she knows how the patient feels because of how she (the doctor) would feel. Given that each person has a different personal history and personality and is likely to be affected by similar medical diseases in very different emotional ways, this is usually a clinical mistake. Curiosity about how another person with an entirely distinct life is experiencing his or her illness is a crucial corrective to over-identification. I always recommend that physicians avoid saying to patients “I know how you feel,” and rather that they learn to say “tell me what I’m missing”.” [Jodi Halpern "Clinical empathy in medical care" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.237]
J.Halpern: “Finally, patients seem to appreciate their physician’s curiosity even when the physician is having a hard time fully understanding the patient. My psychotherapy patients have referred to instances in which I misunderstood them, but stayed interested as they corrected and guided me, as especially therapeutic. Despite older authoritarian norms of the omniscient physician, or perhaps because patients now find it hard to trust this stance, inviting the patient to let you know what you are missing or getting wrong is a very important way to build trust and a therapeutic alliance.” [Jodi Halpern "Clinical empathy in medical care" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.237]
J.Halpern: “We conceptualize clinical empathy as, first and foremost, engaged curiosity. This involves a real interest in going beyond surface emotions and easy sympathetic identifications – seeking to invite and understand a patient’s whole range of emotions.” [Jodi Halpern "Clinical empathy in medical care" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.237]
J.Halpern: “…we can propose a coherent model for clinical empathy in terms of four basic mutually sustaining aims: …1) for physicians to cultivate genuine curiosity about the complexity of human emotional lives, avoiding too simplistic a view; …2) nonverbal attentiveness with the aim of nonverbal attunement. The path to this goal is through practices that instill self-awareness and mindfulness; …3) maintaining genuine, proportional concern for one’s patients; … 4) instilling a culture of social support and self-care in clinicians.” [Jodi Halpern "Clinical empathy in medical care" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.240-241]
J.Halpern: “…rather than compartmentalizing empathy into an additional task, they think of empathy as an adverb describing how they take a history, perform a physical exam, discuss treatment options, resolve conflicts, and so forth. They can listen with curiosity, touch the patient with sensitivity and attunement, and discuss treatment options with respect and concern.” [Jodi Halpern "Clinical empathy in medical care" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.241]
H.Riess: “Evidence supports the physiological benefits of empathic relationships, including better immune function, shorter post-surgery hospital stays, fewer asthma attacks, stronger placebo response, and shorter duration of colds.” [Helen Riess “Empathy in Medicine—A Neurobiological Perspective” JAMA. 2010;304(14):1604-1605]
E.Gleichgericht, J.Decety: “Empathy is also to be considered an important cognitive tool for practitioners themselves… This creates opportunities for knowledge, influencing medical judgment, and therefore contributing to fulfillment of their professional responsibilities. It can, naturally, also lead to feelings of comfort, self-appreciation, and reward, which in turn provide further motivation to help others.” [Ezequiel Gleichgericht, Jean Decety "The costs of empathy among health professionals " in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.248]
J.Shapiro: “The paradox of empathy in medical education: …although there are a plethora of words expended in support of empathy in clinical training and practice, it has not successfully translated into sustainable and effective attitudes and actions.” [Johanna Shapiro "The paradox of empathy in medical education" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.276]
J.Shapiro: “Physicians belong to a profession that has increasingly placed itself within the logicoscientific tradition. Medicine’s positivist worldview, which prioritizes technological progress, hierarchy, certainty, and efficiency, encourages conceptualizing patients as objects and can lead to the doctor feeling alienated from, rather than empathic toward, the patient.” [Johanna Shapiro "The paradox of empathy in medical education" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p. 277]
J.Shapiro: “…the hidden curriculum continues to socialize students to quell their emotions and to reinforce norms against displaying or even feeling/acknowledging emotion. Because they are unfamiliar with and afraid of their own emotional landscape, medical students are also often embarrassed and uncomfortable when confronted with patient emotion (which triggers emotions in themselves). Students who are not able to examine and come to terms with their own psychological lives find it difficult to connect empathically with others.” [Johanna Shapiro "The paradox of empathy in medical education" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.277-278]
J.Shapiro: “Nevertheless, empathy is now typically taught as a set of cognitive and behavioral skills. This cognitive emphasis translates into cognitive-behavioral approaches in which specific verbal and nonverbal phrases or gestures become stand-ins for empathy: “I understand your concern”; “Your language is expressing sadness”; “I grasp that you don’t want to die.” Similarly, touching a shoulder or knee also reductively bcome synonymous with empathy.” [Johanna Shapiro "The paradox of empathy in medical education" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.278]
J.Shapiro: “In particular, the standardized patient (SP) encounters that form the center of the Objective Structured Clinical Examination (OSCE) increasingly used to evaluate empathy and other ‘communication skills’ among students and residents can encourage learners to merely acquire mimetic displays of empathy, superficial language and gestures that earn them success in an examination context but are detached from underlying emotional connection. Because of the evaluative link, students may infer that there are narrowly correct ways of interacting with patients, which in turn can lead to formulaic, impersonal interactions and, ironically, to an appearance of lack of empathy.” [Johanna Shapiro "The paradox of empathy in medical education" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.279-280]
J.Shapiro: “Ultimately, the overall context of medical practice is more important for teaching empathy than the efforts of any one role-model individual, admirable as such efforts may be. This means, that to effectively communicate the importance of empathy to medical learners, we must do no less than change the culture of medicine.” [Johanna Shapiro "The paradox of empathy in medical education" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.282]
J.Shapiro: “Neuroscience research confirms that awareness of a distinction between the experiences of self and others constitutes a crucial aspect of empathy. For empathy to be effective individuals must be able to separate their own feelings from the feelings shared with others, so must have self-awareness as well as other-awareness. Without self-awareness physicians lose perspective, and they experience empathy as a liability. Self-aware physicians, on the other hand, experience empathy as a mutually healing connection with patients.” [Johanna Shapiro "The paradox of empathy in medical education" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.283]
J.Shapiro: “In this empathic medical culture physicians would value and cultivate self-awareness of their own thoughts and feelings, countertransference, and emotional labor. They would be interested in developing ‘insight into how one’s life experiences and emotional makeup affect one’s interactions with others’ and would be able to engage in personal calibration of their own emotional responses to patients. Such a culture would promote role modeling in physicians that was both self-aware and reflexive – outstanding physicians would bring awareness and critical examination to their own behavior and would be able, for example, to reflect on and illuminate for students how empathy was being created and expressed in any given clinical encounter. From these role models students would learn that their impulses to connect with their patients are valid and appropriate, rather than foolishly naïve.” [Johanna Shapiro "The paradox of empathy in medical education" in Jean Decety, (ed) Empathy From Bench to Bedside. The MIT Press, Cambridge Massachusetts, 2012, p.284]

…More quotes will follow.