Empathy We Know What We Mean, But What Do We Measure? Henry
M.
Bachrach,
PhD
pathy, hearing only therapist statements in tape-recorded excerpts of psychotherapy with the patient's statements removed. Such a finding is discordant with the expectation of clinical theory and, therefore, invites independent scru¬ tiny of the methodology from which it emerges to com¬ pare how the phenomena actually being measured corre¬ spond with what is characterized as empathy according to clinical theory. What Is
\s=b\ In recent years, quantitative researches on the empathic process in psychotherapy have resulted in definite recommendations for the technique of psychotherapy and the training of psychotherapists. What is not always observed, however, is that the methods employed for studying empathy have been based on brief segments of patient-therapist interaction in which judgments of empathy do not depend on hearing the patient's communications, and are in several ways discordant with what is meant by empathy according to clinical theory. Evidence suggests that it is the rater's impression of the "goodness of psychotherapy" rather than empathy that is being captured by these methods. (Arch Gen Psychiatry 33:35-38, 1976)
long Empathy psychotherapy. has
been considered a foundation of It has only been recently, however, that efforts have been made to quantitatively study the empathie process in psychotherapy and its relation to the outcome of treatment. In this regard, the work of Truax et al and Rogers and his associates16 is best known and has culminated in definite recommendations for the tech¬ nique of psychotherapy and the training of psychother¬ apists. For example, Truax and Carkhuff5 counsel an ab¬ stinence of interpretation and emphasis on frequent reflection of feeling as a means of facilitating the most productive therapeutic relationship; they also recommend role playing, familiarization with empathy rating scales, and listening to selected excerpts of tape recordings of psychotherapy as an effective method of teaching em¬ pathy. However, what is not always observed is that the methods of studying empathy on which these technical and pedagogic recommendations are based are not con¬ sistently related to the outcome of* psychotherapy,e'8 and may also be discordant with the accrued wisdom of clinical
theory.
Truax2 has concluded that a therapist's empathy may be meaningfully studied without ever hearing anything the patient says. He has shown2 that raters are able to make judgments about the quality of a psychotherapist's emAccepted
From the
publication Feb 4, 1975. Department of Psychiatry, University of Pennsylvania, Phila-
for
delphia. Reprint requests to the Department of Psychiatry, University of Pennsylvania, 922 Gates Pavilion, Philadelphia, PA 19104 (Dr Bachrach).
Empathy According
to Clinical
Theory? Almost irrespective of theoretical orientation, the con¬ cept of empathy, originating in the German word "Ein¬ fühlung" (which means literally to feel within), refers to
the ability of one person to experientially "know" what another is experiencing at any given moment, from the latter's frame of reference, through the latter's eyes. This point has been made repeatedly in many thoughtful dis¬ cussions of empathy and it does not seem necessary to raise again all the nuances that have already been dealt with so comprehensively and well in other places.916 For the present, it only seems necessary to point out that em¬ pathy has been consistently conceptualized as referring to a kind of attitude or way of perceiving that a therapist as¬ sumes and not to something he says or does. This seems the essence of what client-centered therapists have re¬ ferred to as adopting the patient's frame of reference, or what psychoanalysts have referred to as transient, con¬ trolled identifications. Thus, Greenson12
M.
Bachrach,
PhD
pathy, hearing only therapist statements in tape-recorded excerpts of psychotherapy with the patient's statements removed. Such a finding is discordant with the expectation of clinical theory and, therefore, invites independent scru¬ tiny of the methodology from which it emerges to com¬ pare how the phenomena actually being measured corre¬ spond with what is characterized as empathy according to clinical theory. What Is
\s=b\ In recent years, quantitative researches on the empathic process in psychotherapy have resulted in definite recommendations for the technique of psychotherapy and the training of psychotherapists. What is not always observed, however, is that the methods employed for studying empathy have been based on brief segments of patient-therapist interaction in which judgments of empathy do not depend on hearing the patient's communications, and are in several ways discordant with what is meant by empathy according to clinical theory. Evidence suggests that it is the rater's impression of the "goodness of psychotherapy" rather than empathy that is being captured by these methods. (Arch Gen Psychiatry 33:35-38, 1976)
long Empathy psychotherapy. has
been considered a foundation of It has only been recently, however, that efforts have been made to quantitatively study the empathie process in psychotherapy and its relation to the outcome of treatment. In this regard, the work of Truax et al and Rogers and his associates16 is best known and has culminated in definite recommendations for the tech¬ nique of psychotherapy and the training of psychother¬ apists. For example, Truax and Carkhuff5 counsel an ab¬ stinence of interpretation and emphasis on frequent reflection of feeling as a means of facilitating the most productive therapeutic relationship; they also recommend role playing, familiarization with empathy rating scales, and listening to selected excerpts of tape recordings of psychotherapy as an effective method of teaching em¬ pathy. However, what is not always observed is that the methods of studying empathy on which these technical and pedagogic recommendations are based are not con¬ sistently related to the outcome of* psychotherapy,e'8 and may also be discordant with the accrued wisdom of clinical
theory.
Truax2 has concluded that a therapist's empathy may be meaningfully studied without ever hearing anything the patient says. He has shown2 that raters are able to make judgments about the quality of a psychotherapist's emAccepted
From the
publication Feb 4, 1975. Department of Psychiatry, University of Pennsylvania, Phila-
for
delphia. Reprint requests to the Department of Psychiatry, University of Pennsylvania, 922 Gates Pavilion, Philadelphia, PA 19104 (Dr Bachrach).
Empathy According
to Clinical
Theory? Almost irrespective of theoretical orientation, the con¬ cept of empathy, originating in the German word "Ein¬ fühlung" (which means literally to feel within), refers to
the ability of one person to experientially "know" what another is experiencing at any given moment, from the latter's frame of reference, through the latter's eyes. This point has been made repeatedly in many thoughtful dis¬ cussions of empathy and it does not seem necessary to raise again all the nuances that have already been dealt with so comprehensively and well in other places.916 For the present, it only seems necessary to point out that em¬ pathy has been consistently conceptualized as referring to a kind of attitude or way of perceiving that a therapist as¬ sumes and not to something he says or does. This seems the essence of what client-centered therapists have re¬ ferred to as adopting the patient's frame of reference, or what psychoanalysts have referred to as transient, con¬ trolled identifications. Thus, Greenson12
