Does the concept of empathy stroke therapists more than it empowers clients? Whose needs are being met by the definition of empathy – the client’s or the therapist’s? The capacity to participate intimately in another person’s inscape is one definition. Even at their less grandiose – accurate awareness of another’s feelings, say - definitions tend to flatter therapists. There’s no instrument sensitive enough to measure empathy except the human heart, whose conclusions aren’t verifiable. Empathy is as hard to define as it is to achieve, but I suspect it begins with therapists taking clients as they find them and ends with leaving them alone.

The likelihood of empathy may increase the more therapists get to know their clients, but it’s always going to be easier for them to empathise with those who are most similar to themselves. How can somebody who has never experienced bipolar/manic depression empathise with clients who suffer with this? I can’t even begin to imagine. Like so many mental disorders it would seem to be beyond empathy. Claims for empathy should be tempered with caution – acute sensitivity to the feelings of others is less common than tentative speculation. Some have defined empathy as the antithesis of autism, but it might be more realistic to assess where therapists are on the continuum between autism and empathy we all live on. Understanding is almost always an overstatement. What purports to be empathy is often a more or less bungled attempt to discern the nature of a client’s interior world, but ultimately the client is the only one who can fully understand her/his inner life. Efforts to empathise may be appreciated, but perhaps it matters less that therapists understand than that they’re touched by a client’s predicament and prepared – for a fee – to sit by while s/he tries to understand. Therapists’ willingness to accept their own inability or slowness to understand might be more beneficial to clients in the long run.

Empathy has been equated with burden-shouldering, in some instances endowing the therapist with almost superhuman strength. I think it’s misleading to suggest that the therapist takes the weight of the burden from the client. Although the burden may be lifted, it’s a joint effort. Client and therapist might drop the burden any number of times but when they do it falls between them: at this point the client is no longer alone. No longer alone, but separate. The moccasin-donning dimension sometimes attributed to empathy strikes me as far-fetched. Therapy is difficult enough without insisting that the therapist wears the client’s shoes into the bargain. It’s painful to see therapists behaving like so many ugly sisters trying in vain to squeeze their feet into three-sizes-too-small moccasins when it would be more helpful to clients if they kept their feet on the ground.

It’s easier to say what empathy isn’t. It certainly isn’t when therapists choose adherence to an ideology or theory over a client’s needs; although that, too, has been perpetrated in empathy’s name.

When therapists apply their shelf-knowledge without due regard for the individual they’re sitting with, it’s not unlike the way hospitals flaunt their technology to the detriment of the child-bearing mother. The latter, like the client, is made to feel small at a critical moment in her life; a leading lady reduced to a walk-on-lie-down-and-shut-up role. If we see therapists as midwives, supportive but restrained and forbearing in a way doctors so often fail to be, the idea of them absorbing a client’s pain in the way some textbooks recommend becomes as absurd as a midwife ingesting a baby she just helped deliver. The consequences of the burden-snatching that sometimes passes for empathy may be as harmful to the client as they are to a mother prevented from seeing or holding her child. S/he might not be ready to hold the burden herself/himself, but for the therapist to internalise it might jeopardise the therapeutic process.

Far better, in my view, to keep the pain in the space between them where the client can see it and they can work on it. After all, the client is the mother of her/his pain; it doesn’t belong to the therapist.

If the aim of listening isn’t so much to hear others as to allow them the opportunity to hear themselves, the process of empathy as I’m formulating it isn’t so much about bearing clients’ pain as enabling them to bear it themselves. The challenge for a therapist isn’t to absorb a client’s suffering but to hold it in such a way that the client can re-own it when the time is right for them.

Therapists should be wary, in their enthusiasm to empathise, of perceiving clients as empathy-objects. Empathy isn’t something that’s done to a client; it’s part of a process in which s/he takes an active role.

Too much is made of the strength offered to clients by the therapist, too little of the strength displayed by clients who embrace the one-way disclosure that characterizes so many psychotherapies. The client/therapist relationship is both more and less equal than is sometimes appreciated.

What I’ve proposed above is a more modest but at the same time less narrow definition of empathy. For me, suffering, misery and confusion don’t have to be embodied in the therapist. A client’s expectations of the therapist may be more realistic, ultimately, than the therapist’s expectations of her/himself. And if they’re not, well, who’s to say disabusing clients of unrealistic expectations isn’t as important as trying to empathise with them?

Too many definitions of empathy say more about a therapist’s aspirations than a client’s experience. Some who lay claim to empathy will, on closer investigation, turn out to be empathological liars. This doesn’t make them bad therapists necessarily; it serves to remind us that they’re only human beings, not only at the end of the day, but during the therapeutic encounter itself.

Gary Egan