Descriptions and Conceptualization

Abstract

Empathy, a translation of the German wordEinfuhlung, has been described as an elusive and slippery concept with a long history marked by ambiguity and controversy. There has been an ongoing debate about the construct of empathy, described sometimes as a cognitive attribute featuring understanding of experiences of others (cognitive empathy); at other times, as an emotional state of the mind featuring sharing of feelings (emotional empathy); and at still other times as a concept involving both cognition and emotion. Distinctions are made in this chapter between cognition and emotion and also between their corresponding underlying mechanisms of understanding and feeling. The unsettled issue of the differences between empathy and sympathy in the context of patient care is addressed by viewing empathy in patient care as a predominantly cognitive attribute featuring understanding of others’ concerns (cognitive empathy, or clinical empathy) that has a positive and linear relationship with patient outcomes and by viewing sympathy (synonymous to emotional empathy) as a primarily emotional concept featured by sharing emotions and feelings that has a curvilinear relationship (an inverted U shape) with patient outcomes. Distinctions between cognition and emotion, understanding and feeling, and empathy and sympathy are utterly important because of their implications not only for relevant conceptualization and valid measurement of empathy in patient care but for their different consequences in patient outcomes as well.