A comprehensive survey of the literature on empathy reveals many definitions of the concept. The author views empathy, either spontaneous or deliberate, as linked to intuition and perception where the subject's ego boundaries and coherence of self are maintained. Ferreira noted that empathy exists from the youngest days and is related to the mother-child relationship. Spitz postulated a preverbal dialogue which was the precursor of conversation. Erikson pointed out that mutuality provides a safe pole of self-feeling from which the child can reach out for his first love objects.

In therapy the analyst oscillates between experiencing, observing, and conceptualizing. Katz observed that the therapist, regressing in the service of the ego, expands his ego boundaries. This is not the same as overidentification with the patient or the activation of the therapist's unconscious content. Fenichel expressed empathy as identification with another and then awareness of one's own feelings afterwards.