The word 'empathy' is very familiar in everyday conversation and in journalism, especially at the moment when there have been so many sad deaths and extreme dedication to duty. Indeed, there are advocates for empathy who argue that it can and should be taught in medical and nursing courses, and measurement scales for empathy can be found, especially in the US.
what is empathy? It might seem surprising, but empathy did not exist before about 1900. The word was a foreign import, a translation via Greek of the German 'Einfühlung'. It entered English in an unlikely disguise – a theory in philosophical aesthetics to the effect that we can appreciate a work of art empathically by projecting our emotions into it. Currently, the term means the reverse of that – that we are somehow able to experience what other people are feeling.
Like other foreign imports, animal and plant, the word has spread widely and colonised more familiar words and ideas. In ordinary and journalistic speech people say or write, 'I have empathy with your position' and mean just 'I agree with it' or 'I understand where you are coming from'. In other contexts, empathy seems to mean much the same as compassion or sympathy. For example, we might be said to empathise with a friend after a bereavement and mean that we convey our sympathy. Now, if empathy is just another name for sympathy, then we all (psychopaths excepted) have the capacity to respond to tears and laughter.
But there is a large literature devoted to developing empathy as a technical term and providing measurement scales. Presumably it is this technical sense of empathy some consider worthwhile to explain and teach in medical and similar contexts. But what more precisely is that technical sense? There seems to be no single definition of it. Most definitions involve the point that empathy enables us to feel what someone else is feeling, but others extend the definition to include the idea that we should be able to communicate our empathy to the other person.
I shall quote just one definition by writers much respected in palliative medicine. Colin Murray Parkes et al. state that: 'Empathy involves being able to sense accurately and appreciate another's reality and to convey that understanding sensitively'. This definition (and others similar) seems to have two elements: empathy requires that we can feel what someone else is feeling – we must 'sense accurately'; it also requires us to 'convey that understanding sensitively'. If empathy requires the sensitive communication of information then no-one could object. It is desirable in every area of life.
But the definition seems to be suggesting more than that; empathy requires 'sensing accurately' what someone is feeling. This seems to me to be highly problematic. How can we ever be sure that what we are sensing or feeling is similar to, far less the same, as what another person is feeling? It is most likely to be what we ourselves might feel in that situation. As Adam Smith puts it: 'As we have no immediate experience of what other men feel, we can form no idea of the manner in which they are affected, but by conceiving what we ourselves should feel in the like situation'.
It seems to me then that empathy is a highly problematic concept. The problem is that the central element in the definition – being able to feel what someone else is feeling – is not possible; you can feel only your own feelings. Acceptable elements in some definitions of empathy are best expressed in more familiar terms, for example concerning sensitive communication or expressing sympathy.
Nevertheless, it is certainly true that some people, whether professionals or not, are good at lifting our spirits. Another consultant in palliative medicine, Dr Thurstan Brewin, writes as follows in The Friendly Professional
'The ability of one person to lend strength to another (not just in medicine, but also in the way a good leader does, for example when men or women face possible death in some kind of threat or disaster) is a mystery that nobody entirely understands. But, for my money, in medical situations – especially advanced cancer – just being natural and friendly has a lot to do with it. Look at the way some hospital cleaners and porters boost the morale of frightened patients. Do they have special understanding, spiritual inspiration, or powers of leadership? Not usually. How many communication and counselling courses have they attended? None. They are just natural and relaxed, with friendly good humour and no awkwardness or embarrassment...'
However, the view that empathy can and should be taught suggests that feelings are considered by some to be important in a professional context. Doctors will of course have concern for their patients and be aware of signs of distress. But medicine is essentially a practical activity, and the concern will be expressed practically via sensitive discussion and agreed treatment. Feelings require to be damped down or they may get in the way of sound clinical judgement and treatment.
In an analogous way, a musician may be playing a concerto full of emotion, but the performer's attention must be outward to the music and conductor and not inward to their own emotions – or they might lose the place! The emotion is expressed practically via the fingers. Similarly, the doctor's feelings must be transformed into practical activity or they will get in the way of the consultation or the treatment.
Is it possible or important for doctors, or any of us, to be able to recognise feelings in others? Most adults and children (and indeed dogs) can recognise the body language or facial expressions of many common emotions. This ability can be developed and might be useful in at least some branches of medicine, and other areas such as police interrogation. But this is not a matter of empathy, of trying to do the impossible and feel the same as others are feeling, but rather of the recognition and interpretation of facial and bodily expressions. Enthusiasm for this alleged skill must of course be tempered by recalling the words of Shakespeare in Macbeth
Duncan: 'There's no art
To find the mind's construction in the face