Empathy and its Vicissitudes1

Most experienced psycho-analysts will agree that in order to carry out effective psychotherapy a knowledge of psycho-analytic theory and the intellectual understanding of a patient is not sufficient. In order to help, one has to know a patient differently—emotionally. One cannot truly grasp subtle and complicated feelings of people except by this 'emotional knowing'. It is 'emotional knowing', the experiencing of another's feelings, that is meant by the term empathy. It is a very special mode of perceiving. Particularly for therapy, the capacity for empathy is an essential prerequisite. Although I believe these points are well known it is striking how little psycho-analytic literature exists on the subject of empathy. In their technical papers, Freud (11), (12), Ferenczi (8), Glover (13), Sharpe (23), and Fenichel (6) comment only briefly on this important topic. There seems to be a tendency among analysts either to take empathy for granted or to underestimate it. There also seems to be some antagonism between theory and empathy.2 The systematic theoreticians have neglected this field and the empathic clinicians write little theory and then unsystematically (Reik (21), (22)). Finally, one frequently hears the phrase that empathy cannot be taught or learned; one either has it or one hasn't. Perhaps all these elements play some role in the relative obscurity of this important chapter.

Before proceeding further, I would like to attempt a preliminary definition of empathy as we use the term in psycho-analysis. To empathize means to share, to experience the feelings of another person. This sharing of feeling is temporary. One partakes of the quality and not the degree of the feelings, the kind and not the quantity. It is primarily a preconscious phenomenon. The main motive of empathy is to achieve an understanding of the patient.

Empathy is to be differentiated from sympathy since it does not contain the element of condolence, agreement, or pity essential