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'Empathic Civilization': Why Empathy Is Essential For Doctors And In Conflict Resolution

Posted: 02/23/10 07:54 AM ET

In "The Empathic Civilization," Jeremy Rifkin makes the important argument that empathy can be a potent force to alleviate global conflicts. I wholeheartedly agree -- and from my work on empathy in healthcare settings and post-war reconciliation, I believe we need empathy based on genuine curiosity about how other people feel, as well as emotional connection with them. This claim is more radical than it might seem. The accepted wisdom is that we need sympathetic identification, in which we see ourselves as all "in the same boat" to generate empathy and redress differences. Yet this is counter to reality -- we are never in the same boat as another person. What we need to cultivate is genuine interest in each other's distinct experiences.

Patients taught me this. Nothing shuts people down so quickly as a doctor saying "I know how you feel;" nothing opens up the dialogue as well as "Tell me what I'm missing." Worse, a doctor is apt to project an agenda onto patients, if he (or she) thinks he already knows how they feel. Cardiac surgeon Christiaan Barnard, intent on performing the first successful heart transplant, persuaded patient Philip Blaiberg to undergo the grueling procedure. Barnard had been crushed by his first experiment's failure (the patient died), and felt that he was representing Blaiberg's needs as well as his own when he urged Blaiberg to join him in a glorious mission together. Yet clearly the two were not in the same boat -- Blaiberg recovered initially, but then suffered painful complications and died, while Barnard became famous.

The clinical empathy needed from doctors differs from sympathy in three ways: First, empathy seeks the particular perspective of another, not generalizations or stereotypes. Second, empathy involves feeling curious about what you don't understand, rather than believing you already know another's feelings. Third, empathy involves tolerating emotional ambivalence; for example, to empathize with someone you are angry at, you need to accept both their feelings and your own.

These three aspects of engaged curiosity are also crucial for reconciling former enemies in the aftermath of war. Rifkin importantly points to South Africa's Truth and Reconciliation Commission as hope for a global shift towards empathy. However, thus far, the encounters described often emphasize sympathy and forgiveness more than complex empathy. For example, psychologist Pumla Gobodo-Madikizela writes about two South African women whose husbands police colonel Eugene de Kock murdered. Visiting him in prison, they see de Kock chained and despairing. Feeling tender sympathy for his vulnerability ("I would like to hold him by the hand"), they forgive him. However admirable their stance, what I find interesting is what the two widows don't express -- they don't express curiosity about who this man really is, nor do they discuss any ambivalence about him. Forgiveness captures our attention, but we need examples of more complicated empathy to see how people can rebuild their societies over time.

One such example is that of the Bosnian, Serb and Croatian mothers, former enemies, who have worked together for years to locate and build proper memorials for their sons. Interviews suggest that while sympathy first drew these women together, those who developed resilient relationships show a less sentimental, individualized empathy for each other. Two such women, Dobrinka, a Serb, and Marija, a Croat, have worked together for a decade. They often disagree and sometimes dislike each other, yet respect each other and seek to know what each other thinks to strategize and solve problems. In listening over the years, they have learned about each other's life struggles, and often rely on each other for support at crucial times.

Still, one might ask, how can we develop empathy during active conflict? As a hospital psychiatrist called to calm difficult situations, I have seen that when intense anger and fear undercut sympathy, curiosity can still evoke empathy. For example: a nineteen-year-old was blocking the door to his dying mother's room, threatening to shoot the nurses if they tried to give his mother more sedating pain medication. Security ascertained that he had no violent history nor a gun, yet the entire team, furious, wanted to send him to the psychiatric hospital for endangering others. I asked them why they thought he was doing this. This engaged their curiosity and they pieced together his history. The son had spent almost no time with his mother since moving across the country the year before to start college. He'd only been called home when her cancer had recurred and she was dying. Desperate to talk with her, he couldn't bear her being sedated further. Thinking about this made the doctors and nurses recall their own fears about losing loved ones. In this process, they shifted to genuine empathy for the young man. Once they approached him with genuine concern, he recognized his own distress and stopped making threats. He phoned his father, who was staying away because he couldn't deal with his son. When the mother died, the father held the son in his arms as they consoled each other.

In his important book, Rifkin inspires us to cultivate our possibilities as homo empathicus. To do so, in my view, requires genuine interest in why other people do what they do, even when feeling threatened. When empathy is guided by a deeper understanding of each other's perspectives, it offers enormous promise for helping us build global cooperation.