The Pragmatics of Empathy

For a generation at the very least, there has been no disagreement within psychoanalysis about the essential role of empathy in making possible the accomplishment of the clinical goals of its procedures (see Kohut, 1959; Stone, 1961, 1981; Schwaber, 1981; Gedo, 1981, chapter 6; Gehrie, 1993). We also have consensus about defining empathy as a mode of observation based on a trial identification with the person observed, predicated on the common human characteristics of the participants. It is not uncommon, however, to encounter statements in the literature equating empathy with the acceptance without demurral of the subjective viewpoint of the analysand (see Kohut, 1984, p. 174; also Schwaber, 1983); self psychologists, in particular, tend to look upon any analytic intervention that causes the analysand pain or humiliation as “unempathic.” Hence it is by no means obvious how, in practice, analysts should conduct themselves “empathically.” Is it sufficient to devise interventions informed by the results of empathic observation? Should the analyst, in addition, affirm the legitimacy of the analysand's subjectivity or strive to avoid injuries to the latter's self-esteem? Is it desirable to make certain that the analysand feels the “healing power” so often attributed to empathy?

In my clinical experience, most analysands regard the ordinary routines of psychoanalysis as empathic to a degree unprecedented in their past: the nonjudgmental effort to discern their motivations is generally appreciated as true acceptance. Whenever this is the analysand's reaction to treatment, any doubts we may express about the rationality, wisdom, or accuracy of his or her subjectivity is easily accommodated as helpful and potentially illuminating. These are the conditions Zetzel (1965) called a therapeutic alliance, Winnicott (1954) and Modell (1976) named a “holding environment,” and