Written by Positive Psychology

Empathy is an emotion similar to understanding that people have varying levels of. In this piece, we will discuss the benefits of showing empathy as a therapist, as well as how to show empathy as a therapist.

We will also discuss strategies for promoting empathy in people who do not have high baseline levels of empathy. Let us begin, though, by defining empathy.

What is Empathy? A Definition

According to the Merriam-Webster Dictionary, empathy is:

“the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner; also : the capacity for this”.

One recent neuroscience paper defines empathy as “a multifaceted construct used to account for the capacity to share and understand the thoughts and feelings of others” (Decety & Yoder, 2016). The authors of this paper go on to highlight a few aspects of empathy, including what they call emotional empathy and cognitive empathy, an important distinction in academic work involving empathy. They describe emotional empathy as “the capacity to share or become affectively aroused by others’ emotional states at least in valence and intensity”, and they describe cognitive empathy as “the ability to consciously put oneself into the mind of another person to understand what she is thinking or feeling”.

To put it another way, according to that way of thinking, empathy can be broken into at least two parts: *feeling* the way someone else feels, and *understanding* how someone else feels. In other words, empathy is made up of being able to put yourself in someone else’s position both intellectually and emotionally.

This is just one (incomplete) way of breaking down empathy and there are several other interesting definitions. For our purposes, we can keep it simple and consider empathy to be the ability to put yourself in someone else’s position to understand how they are feeling, as well as being sensitive to how someone else is feeling.

Now that we know what empathy is, how does it relate to therapy and counseling?

Why is Empathy Important in Counseling

One study found that psychotherapy clients “viewed empathy as integral to the personal and professional relationship they had with their psychotherapist”, and believed that empathy from their psychotherapist benefited their psychotherapy sessions (Macfarlane et al., 2017).

Some of the specific benefits of empathy listed by clients included greater levels of trust between the client and therapist, a greater level of self-understanding for the client, and higher levels of feeling happy and secure. While this study used self-report measures for their findings, the client’s opinion of psychotherapy is the most important one, so these findings are relevant.

Another study interested in psychotherapist empathy examined the number of empathy therapists demonstrated from client to client, with all clients seeking therapy for problem drinking (Moyers et al., 2016). This study found that when therapists demonstrated more empathy than they usually did, the client was less likely to be drinking by the end of treatment, and when therapists demonstrated less empathy than they usually did, the client was more likely to be drinking by the end of treatment.

This shows that treatment outcomes can depend on the level of empathy shown by the therapist, even with the same therapist treating the same issue. On the flip side, some studies have even shown that low levels of therapist empathy may not only fail to reduce problem drinking but can even increase levels of problem drinking in the client (Moyers & Miller, 2013).

While empathy can be beneficial for clients, it may also be beneficial for therapists. Consider the fact that general care practitioners who empathize with their patients are more likely to have higher job satisfaction and lower levels of burnout than those who do not empathize with their patients (Halpern, 2003).

Of course, general care practitioners are not the same as therapists, so we cannot say with certainty that these findings apply to therapists, but they are similar jobs with similar clinician-client relationships, so it is possible that therapists who practice empathy would see the same benefits.

If showing empathy in the therapy process can be beneficial for the client, exactly how can a therapist demonstrate empathy?

How to Show Empathy (in Counseling)

The Macfarlane (2017) study, discussed above, indicates that clients benefit when they feel their therapist is demonstrating empathy. It is important, then, to discuss ways that therapists can show they are being empathetic. Therapists involved in Child-Centered Play Therapy (CCPT) indicate that some of the ways they convey empathy in-session is by “matching … facial expression, physical movement, affect vocal tone and inflection, and energy level” (Jayne & Ray, 2015).

Other things therapists can do to show empathy towards their client include:

  • not interrupting the client,
  • not dismissing the client’s beliefs,
  • not being judgmental,
  • and not talking too much in general (Elliott et al., 2011).

By not doing any of these things, the therapist can show their client that they respect the client and are trying to understand what they are thinking, rather than imposing a premeditated, one-size-fits-all treatment plan on the client. Combined with Jayne & Ray’s (2015) findings, it is safe to say that therapists can show they are being empathetic to their client by matching the client’s body language and mirroring their verbal style, as well as allowing the client to speak in a way such that they feel they are really being listened to.

These are all things therapists can work on in their practice, but it might still be hard for therapists with low levels of empathy to put these teachings into practice. For that reason, it is worth exploring ways that therapists can raise their own levels of empathy so that these empathy-indicating behaviors come around naturally in their sessions. 

How to Cultivate Empathy (as a Counselor)

A type of mindfulness meditation called loving-kindness meditation (LKM) has been shown to increase cognitive empathy levels in masters-level counseling students (Leppma & Young, 2016). The authors say that:

“the practice begins with directing loving-kindness, or compassion, toward one’s self. As a sense of respect, friendship, and love or compassion develops with oneself, the practice then expands to include others”.

Just six weeks (six-hour-long, weekly sessions) of practicing this loving-kindness meditation was enough to increase empathy levels, indicating it is an accessible way for all therapists to increase their own levels of empathy.

More information on increasing therapist empathy can be borrowed from attempts to increase empathy in physicians. Again, physicians are of course not the same as therapists, but the similar clinician-client relationships that arise in both professions indicate that what works for physicians is a good starting point for investigating what might work for therapists and counselors. One relevant meta-analysis examined a number of studies that attempted to increase levels of empathy in medical students (Kelm et al., 2014). This analysis found that some successful interventions focused on communication skills and roleplaying.

Specifically, one such type of intervention focusing on communication skills would have a medical student interact with a stand-in patient in a recorded session. The student would then receive feedback on how they interacted with the patient and given advice on how to demonstrate more empathy. Another type of intervention focusing on roleplaying would have the medical student act like a patient during a checkup so that they could see what it felt like to be on the other side of a physician-patient interaction. Both types of interventions were found to be effective in increasing empathy levels in the medical student.

Physicians have also claimed that role modeling empathy is the most effective way to teach it to physicians (Shapiro, 2002). Specifically, showing a medical student a physician-patient interaction where the physician demonstrated empathy and then discussing the physician’s use of empathy was considered by the physicians involved in the study to be the most useful way to teach empathy.

Along with the Kelm et al. (2014) findings, this indicates that the most effective way to teach empathy to therapists would be to teach empathy to prospective therapists as part of their training. Those who are already therapists can set up their own roleplaying situations and communication skills trainings, although LKM can be an excellent alternative and supplement.

A Take Home Message

Empathy is an important human emotion that can greatly benefit clients in therapy and may potentially benefit therapists as well. Demonstrating empathy is something that therapists can consciously do, and there are also ways that therapists can increase their own levels of empathy so that it comes more naturally during sessions.

While we may not all be therapists, we can all practice empathy when interacting with our friends, loved ones, and even strangers. Considering where someone else may be coming from while interacting with them can go a long way in forging positive connections.

Keywords empathy, counselling