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Few people would deny that empathy always has been an important aspect of psychoanalytic treatment. However, as Berger points out in Clinical Empathy, discussions in the literature about this topic have increased dramatically over the past 10 years. To a large extent, this rising interest is the result of Kohut's emphasis on empathy as both the essential healing factor and cornerstone of data collection in psychoanalysis.
In the first section of his book, in which he reviews concepts of empathy, Berger agrees that empathy facilitates the healing process and data collection, but he does not emphasize these ideas as strongly as the self psychologists; nor does he endorse other self psychological views about empathy. He only briefly discusses the role of empathy in the strengthening of self-structure through the analysis of selfobject transferences and transmuting internalizations. He does not agree that empathy occurs when the patient “feels understood” or that pathology necessarily stems from a lack of parental empathy in childhood. He does not believe that empathy is “warmth” and “acceptance,” a view often attributed to self psychology. Instead, he assumes a broader, more traditional perspective, maintaining that “the term empathy should be used only to denote experientially knowing another person's inner state” (p. 228). It consists of an emotional component, which is the clinician's personal and theoryless reactions to the patient (similar to the self psychological concept of empathy as “experience near”), and an intellectual component, which is derived from the theories that guide and give meaning to the clinician's emotional experience (this component seems to violate Berger's definition of empathy as “experientially knowing”). In the psychoanalytic context, empathy is used to promote growth; but in other situations, according to Berger, it could be used to manipulate and hurt people.
Berger's definition of empathy broadens to the more generic idea of being