Empathy in psychiatry and psychotherapy

Abstract

Empathy is the epicenter of the theoretical and clinical interest of many different scientific domains, constituting a common term in different fields as these of psychology, psychiatry, clinical psychopathology, neuroscience, psychotherapy and psychoanalysis. Studying the phenomenon of empathy requires distinguishing the empathy as a method of observation of psychological phenomena from the empathy as a component of the therapy of psychopathological phenomena. In this case, beyond the empathic understanding, the optimum responsiveness of the therapist is included. Empathy means sharing the psychological and emotional state of another as if you were able to sense one's private world. This emotional sharing is a temporary situation and concerns the quality but not the quantity of the emotional experience. The modern scientists of neurobiology and neurobehavior distinguish three types of empathy: the emotional, the cognitive and motivational which help the interpersonal relations occurring in complex groups of society where the transgenerational relationships between parents and offspring are essential for the survival of species. Jaspers introduces, already by the beginning of the 20th century in his monumental work ''General Psychopathology'', the notion of empathy as an interpretative and a diagnostic tool in psychiatry and psychopathology. Meanwhile psychoanalysis, mainly during its early course, was not impressed by this term. The answer to this seems to be that the term empathy is related to the intersubjectivity and the interpersonal relationship, fields that were not really attractive at this point of time for the psychoanalytical theory which during the period of the founder of the psychoanalysis was initially mainly focused on the "intrapsychic" field. However, during the course of time and chiefly with the contribution of Kohut and Greenson, the importance of the concept of empathy is emphasized in the clinical psychoanalysis and efforts are made regarding the clarification of the nature and the psychological mechanisms that operate in this complex intuitive (feeling the other through the interpersonal communication) form of knowledge. The quality of the relationship between the therapist and the patient (therapeutic alliance) plays a fundamental role in the positive outcome in any form of psychotherapy. Empathic understanding plays an important role in the quality of the therapeutic relationship. In the field of general psychiatry, the focus of research for the role of empathy and the potential of its application, has been until today limited. The lack of a model for the application of empathy in psychiatric and psychotherapeutic practice is an important challenge for the training of the new psychiatrists.