Abstract
The past decades have seen an explosion of studies on empathy in various academic domains including affective neuroscience, psychology, medicine, and economics. However, the volumes of research have almost exclusively focused on its evolutionary origins, development, and neurobiological bases, as well as how the experience of empathy is modulated by social context and interpersonal relationships. In the present paper, we examine a much less attended side of empathy: why it has a positive impact on others? After specifying what the construct of empathy encompasses, we briefly review the various effects of empathy on health outcomes in the domain of medicine. We then propose two non-mutually exclusive mechanistic explanations that contribute to explain the positive effects of physician empathy on patients. (1) The social baseline theory (SBT), building on social support research, proposes that the presence of other people helps individuals to conserve metabolically costly somatic and neural resources through the social regulation of emotion. (2) The free energy principle (FEP) postulates that the brain optimizes a (free energy) bound on surprise or its complement value to respond to environmental changes adaptively. These conceptualizations can be combined to provide a unifying integrative account of the benefits of physicians’ empathetic attitude on their patients and how it plays a role in healing beyond the mere effect of the therapeutic alliance.
Highlights
It is widely agreed upon that empathy is a good thing, and that it should be the basis of attitudes towards patient care, or should at least play an important role in the doctor-patient relationship alongside deductive logic, physical examinations, and treatment
We examine a much less attended side of empathy: why it has a positive impact on others? After specifying what the construct of empathy encompasses, we briefly review the various effects of empathy on health outcomes in the domain of medicine
We examine the current knowledge in neuroscience to offer an integrative and comprehensive perspective on the neurobiological and cognitive mechanisms that underlie the positive role of empathy in medicine
Summary
(2) The free energy principle (FEP) postulates that the brain optimizes a (free energy) bound on surprise or its complement value to respond to environmental changes adaptively. We propose two non-mutually exclusive mechanistic explanations that contribute to explain the positive effects of physician empathy on patients. These conceptualizations can be combined to provide a unifying integrative account of the benefits of physicians’ empathetic attitude on their patients and how it plays a role in healing beyond the mere effect of the therapeutic alliance
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