Understanding empathy
A commonplace definition of empathy is ‘understanding other people’s feelings’ — but the quality of, or capacity for, empathy remains complex and hard to pin down.
Empathy has two sub-types. Cox et al. (2011) note:
Although the literature has yet to agree on a precise definition… a consensus has emerged that views affective empathy (AE) as the ability to share the emotional experiences of others, i.e. a visceral reaction to their affective states; while cognitive empathy (CE) denotes the ability to take the mental perspective of others, allowing one to make inferences about their mental or emotional states.
So, what do we talk about when we talk about empathy?
First, something that is not immutable nor innate.
According to Cox et al., people who suffer psychopathy, schizophrenia and narcissism show deficits in affective, but not cognitive, empathy; individuals with autism and bipolar disorder tend to lack cognitive (but not affective) empathy; dementia sufferers are impaired in both.
This explains a lot about the current situation in US politics: it isn’t that the maniacs behind the wheel lack empathy — they lack a specific kind of empathy. They seem perfectly cognizant of other people’s cognitive states, i.e., what people think of them; for all their ability to care about other’s feelings — that is, affective empathy — they might as well be concrete statues on ice pedestals.
Arguably, the circus-freak-in-chief may be in the midst of a mental decline that prevents him from accessing either.
Walk in whose shoes?
Part of what makes empathy tricky is that platitudes about universal peace, love and understanding unavoidably, if awkwardly, demand that we fail to distinguish between empathizing with, say, Elon Musk’s megalomaniacal yearnings and the desires of undocumented immigrants to live in safety.
If empathy is an ipso facto good then Trump was right to say, in 2017, that white nationalist protesters included “some very fine people.”
Empathy, like antibiotics, requires situationally appropriate usage.
As with antibiotics, it can be life-altering, even life-saving, when correctly deployed.
This means identifying when, and for whom, empathy is appropriate; which empathetic subtype is most relevant; and how to foster and express that empathy.
Writing can be a tool throughout this process; it can enable us to cultivate mindful compassion, rather than kneejerk emotional responses.
Empathy for whom?
The unwell
Healthcare is a setting which makes immense demands on cognitive and affective empathy. If not replenished, “health provider burnout begins early on in medical training,” Chen and Forbes (2014) reported.
They conducted a review study of investigations into the benefits of reflective writing for medical, dental, pharmaceutical, etc. students. The approach was rigorous: Chen and Forbes discarded over 1,000 studies that were primarily qualitative and focused on eight that provided quantitative measures of empathy outcomes.
The results?
“A significant change in student empathy was observed in 100% of the studies.”
The researchers concluded that, “early reflective [writing] interventions targeted against compassion-loss can have profound potential on physician well-being and patient outcomes.”
Older people
Among the quantitative research Chen and Forbes reviewed was a 2009 study by Westmoreland et al. that aimed to reduce prejudice against the elderly, “which is prevalent among medical trainees.”
Students completed initial and final reflective writing exercises, and met with elderly people. Following the training, student attitudes “were significantly improved in seven of 14 items, demonstrating better attitudes toward being with and listening to older people and caring for older patients.”
Given the universality of illness and ageing, these findings are important. Writing can and should be a way to reflect on what it means to be vulnerable, to need help, and to be afraid.
Fear has a nasty way of metastasizing into us versus them, or me versus you.
By writing through our responses to vulnerability and uncertainty, we can use cognitive and affective empathy to harness our fears and let them guide us towards community, connection and compassion.
Marginalized communities
We humans are implacably prone to prioritize our own perceptions and experiences, which can create massive gaps in cognitive and affective empathy for ‘others’.
A study by Roche et al. (2007) aimed to foster greater understanding of Native American culture and healthcare needs among pharmacy students.
The participants completed assigned readings, kept reflective journals, completed research on health topics of particular relevance to Native communities and met with Native American and non-Native speakers.
Students “expressed perceptions of professional growth in several dimensions including cultural appreciation and respect, awareness of health disparities and the need for social responsibility.”
This type of intervention could be replicated with almost any group, whether based on ethnicity, gender, culture, or on physical or mental health conditions.
Why empathy?
Mutual understanding
Writing facilitates insights into other people’s experiences, beliefs and cultures; it also requires those insights as a basis for effective communication. This reciprocity is one of the reasons that language learning prioritizes written expression.
To speak another language enables one level of communication; to become adept at its written expression requires deeper, more complex cognitive skills.
Guan et al. (2024) argue that “empathy could serve as a foundation for intercultural dialogue, and dialogic empathy is the main embodiment of empathy ability in the discursive construct.”
To that end, Guan et al. designed a study that used empathetic virtual reality-based learning (E-VRL) to enhance writing skills by providing “learners with access to authentic experiences and further promote learner empathy.”
When compared to a control, students in the E-VRL group “had better overall empathy ability… especially cognitive empathy.”
Pedagogy of empathy
Education must work against the trope that empathy is ‘poor you’ and work towards a more complicated conception of emotional and a cognitive mutual understanding.
“For empathy to be a useful/meaningful practice in the teaching of writing, writers must be conscious of the ways empathy has been used to appropriate, alter, or erase the experiences of the other. Writers must understand that empathy opens a channel of communication that flows two ways: we empathize and are the objects of empathy... Empathy is not just a practice of the privileged.” (McCurrie (2020).
To reach that awareness begins with an awareness of our own minds and assumptions. Didion famously said she wrote to find out what she was thinking — and so should we all.
I am often surprised at how my mind reveals itself in writing. Beliefs, tropes, versions of events that exist unquestioned in my head change shape and quality as I write. Even when I’ve ‘thought it over’ rigorously, the business of putting an idea or experience into written words uncovers new facets.
McCurrie suggests writing classes include “activities and assignments that enhance the skills associated with empathy: listening, perspective-taking, evaluating, judging, and reflecting.”
Some activities I use:
Peer-interviews
Students generate a list of questions as a whole group, then split into pairs and interview each other. The first step is important as it gives them ownership of the questions — they can’t say, ‘these are boring’ if they created them.
Shifting first-person POV
Students take a first-person text, choose another character to become the narrator, then rewrite a scene/event from their point of view.
How it feels to be _____ me
This exercise is based on Zora Neale Hurston’s essay ‘How it Feels to be Colored Me’. Students choose an aspect of their identity then write a semi-structured piece (usually, I include guiding questions) in which they reflect on what it means to them, how others may see it, and how it affects their interactions.
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Writing is the best, the only tool we have for protracted metacognition. Which in turn is the best tool we have for developing the thoughtful, informed, prosocial empathy.
Loved this one! Empathy is encouraged with intergenerational friendships, among other things like the studies you cite. Thanks Cila..