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PATIENTS WITH CHARACTER PROBLEMS have forced analysts to respond uniquely. Havens (1976) suggests that certain patients required
heightened empathic activity—the attempt to be with the patient emotionally—in order to create a transference neurosis. Patient with specific character problems may restrict our usual empathic approach by detachment, provocation or contempt and make it difficult to maintain an analytic empathic attitude. The narcissistic patient impedes empathy and leads us to boredom, drowsiness, even sleep. We remind ourselves that such patients are avoiding relationships and we try to grasp the defensive nature of their isolation. The widened scope of analysis with borderline patients puts the analyst in a line of fire where one tends to be initially reactive rather than reflective and empathic.
In discussing empathy it is critical to separate the process of sensing and trying to experience how another person feels from what one does or doesn't do with the experience. Mendelson (1988) demonstrates how empathy must be coupled with the analyst's self observation and judgement to be useful to the patient. Blechner (1988, p. 305) notes that combining the definition of empathy with "constructive intentions … leads to theoretical confusion." Schwaber (1984) also emphasizes separating empathy as a mode of listening and gathering data from the technical position following it.
Moses (1988) and Book (1988) consider the misuse of empathy which follows some supposed empathic experience with a patient. Such misuse may include commenting or not commenting or how and at what time we comment.
My focus today will be on some limitations of empathy along with several hazards of excessive empathic immersion.