Delivered on Saturday, 19th October 2024 at Mumbai
By Dr Sudhir Bhave
Empathy: Beyond Psychiatry
Respected chairpersons, and dignitaries off the dais, I am privileged to be standing before you today as the new zonal president. I consider it an honor to be delivering this prestigious address at Mumbai.
Empathy is a subject we deliberate upon right since the time we enter the portals of the medical college as undergraduate students, getting more importance as we join the department of psychiatry. As we know, psychiatry is largely about empathy.
To put it simply, empathy can be defined as the ability to understand another person’s feelings. It involves an emotional resonance that can lead to compassion and deeper relationships.
Empathy in Psychiatrists
Empathy forms a cornerstone of psychiatric training and practice. When I was a postgraduate student, we were taught that if we could empathize with a patient, he suffered from neurosis – if not, he had psychosis. Empathy in a psychiatrist is so crucial that only if a psychiatrist has an adequate capacity for empathy can he be called a “good” psychiatrist
The Basis of Human Behavior
Empathy not only has psychological or a spiritual justification, but also a scientific one. I will elaborate upon this.
Human behavior, to put it simply, is a result, largely, of three factors – genetics, early childhood environment, and the ongoing life situation. The first two are beyond our control, and the third one, only partly so. If the very roots of one’s behavior are beyond one’s control, can he really be held responsible for his thoughts and actions to the extent the society would love to believe? As the iconic poet Sahir Ludhianvi has so aptly put in a sher, through the vocals of Mohammad Rafi in the iconic movie Pyasa (1958) – “Hum ghamzada hain laayein kahan se Khushi geet; denge wahi jo payenge iss zindagi se hum” (A heartbroken man, how do I sing words of joy? I can give back to life only what it has given me). If I am raised by a pair of specific parents, in specific circumstances, with specific significant events in my life, I am bound to think and act in a specific fashion dictated by the predisposing factors.
The eminent American neuroscientist Benjamin Libet had demonstrated in an innovative experiment in 1983 that even before the cerebral cortex consciously decides to carry out an action, the brain sends a “readiness potential” approx. 350 milliseconds before that “decision”. Though the conclusions have some detractors, it was shown that our voluntary actions are not as voluntary as we have believed thus far, but arises from something deeper. This fact supports a case for unconditional empathy.
Types of Empathy
Empathy is of two types – cognitive and affective. The former relates to the ability to understand another person’s perspective. It is vital, amongst other things, in conflict resolution, negotiations, and leadership. Affective empathy, on the other hand, is sharing in the emotional experiences of another, being truly in sync with the other person’s experience
Empathy is vital for all types of human interactions. Some examples are as follows. Empathy has a big role to play in personal relationships. It is this emotion that fosters connection, and better equips us to navigate conflicts and enhance mutual understanding.
Empathy is very important in education. It helps teachers create a supportive learning environment that enhances student engagement, and, consequently, academic success. Empathetic teachers can foster a sense of belonging in the student.
Empathy in healthcare is fundamental to patient care. Patients perceive empathetic physicians as more competent and trustworthy, impacting the overall medical experience. Evidence shows that high levels of empathy in the treating team improves the patient outcome.
The practice of empathy has a significant role in personal growth.
Gratitude is an important component of spiritual development of an individual. One way to develop this is to empathize with others’ struggles, which evokes feelings of gratitude for one’s own privileged circumstances.
Compassion, a spiritual virtue, intertwines closely with empathy. Most religions emphasize on compassion through empathy for the other. Hinduism comments upon ahimsa, or non-violence in the context of both physical and emotional harm. Rehm, or compassion, is a central tenet in Islam, and is based on empathy with the plight of others. Forgiveness, another virtue, rests on empathy. One can forgive others more easily if one empathizes and finds other’s actions understandable. Marin Luther King, Jr, had once famously, and so aptly, said, “Forgiveness should not be a one-time event – it should be lifelong attitude.”
Social Justice and Activism
Empathy is closely linked to activist movements like the civil rights movements, men supporting feminism etc. One cannot engage in activism for “others” unless he empathizes with the wronged. Mother Teresa says that “Changes always arise from a place of empathy and compassion.”
Dalai Lama says “Love, empathy, and compassion are not luxuries. They are necessities. Without them, humanity cannot survive.” Not only humanity, but life cannot survive. If we study the causes of species’ extinction, cruel, senseless hunting, arising out of a misplaced sense of bravado, is a prominent one
Challenges to Empathy
The Rise of Technology
In the Modern Society, increasing use of screens and social media has diminished face-to-face communication and emotional connection. Digital interactions often lead to misunderstandings, making it difficult to empathize with others
The Empathy Gap
Individuals empathize more with those who are like them – in color, caste, community, religion, nationality – with less empathy for those who are different. Worse still, bias can perpetuate divisions and reinforce stereotypes, hindering social progress.
Addressing the empathy gap requires conscious efforts to engage with diverse perspectives.
Negative Emotions
Some emotions like pity, fear hinder empathy. For example, fear of people belonging to a particular religion makes it difficult to empathize with its followers. Our work is to address the archetype that has, in some cases, pervaded the psyche of the entire globe.
The real test of empathy lies in empathizing with the “difficult to empathize with”. Some examples are people with specific personality disorders, terrorists, rapists, child abusers, etc. Even strong empaths may experience cognitive dissonance in reconciling a need for empathy with the need to disapprove an undesirable act. But it needs to be emphasized that empathy is not endorsement – it only means acknowledging the humanity of someone who was raised to think differently. If I am born in Syria, raised by militants radicalized in the philosophy of ISIS, fed anti-Christian, anti-American propaganda since my childhood, will I become anything but a terrorist? I strongly doubt that. Perhaps empathy lay at his heart when Mahatma Gandhi famously said, “Hate the sin, not the sinner.”
For me empathy goes beyond Homo sapiens – it would be desirable to empathize with anything that breathes. It would be desirable to empathize with that poor hen, that is being carried to be slaughtered, in an uncomfortable, overcrowded cage, terror-stricken, with a foreboding sense of something sinister going to happen. Empathy lies in imagining the extreme anxiety in a goat that is going to be “sacrificed”, held at its two ends, a butcher raising his sword above her neck, surrounded by a cheering crowd. (And all this only to please the palate a Homo sapiens [translated, ironically, from Latin as the “wise human”] sitting somewhere afar)
Empathy Deficit
There is no doubt that the world suffers from a huge empathy deficit. Often, we fail to empathize with our family members who disagree, ditto for our neighbors, members of another community, people who carry out socially undesirable acts, and so on. The world would be so much more of a peaceful and happy place if we all were hardwired for unconditional empathy.
Cultivating Empathy
The good news is that the capacity to empathize is not necessarily hardwired at birth – it is a skill that can be learnt. The harder you work at it, the better you get. Some ways to be a better empath are as follows
Listening Carefully
In mental health professionals, active listening is a “technique” to be taught. A medical student is taught to listen attentively, make appropriate gestures to indicate that he is listening, reflect the patient’s statements on him to show that he’s being understood, and so on. But being humane just calls for focused listening – listening carefully, trying to understand the other person’s predicament, being in sync with his thoughts and emotions, with no compulsion to show that he is understood.
Biases often preclude this kind of listening, listening to really understand, and not merely to eagerly and hastily react with your own preconceived thoughts
Perspective-Taking Exercises
Reading literature that explores diverse experiences and participating in community service for the “have-nots” helps understand the plight of others. It helps understand different viewpoints and foster a sense of shared humanity.
If empathy is so desirable, why is it not taught in schools? Worse, why is it not taught to medical students, or the students of psychiatry? It is high time the society planned and imparted development of this human attribute at all levels that make a difference.
It would be beautiful to have empathy for every living being, no matter what species it belongs to; every human being, no matter what caste or community he belongs to, what beliefs he harbors, or what acts he indulges in – for, given his circumstances, he could not have been different.
I am reminded of an anecdote mentioned in the biography of the iconic jurist Nani Palkhiwala. I hugely admire him for his exceptional brilliance, his great humility, and his compassion. Once, as it goes, Palkhiwala was having a very important meeting with some high-profile clients. In the midst of this, suddenly reminded of something, he called out for his house-help and instructed him, “When you clean the dining table, take care not to disturb that butterfly sitting on the table’s edge. It has been sitting there for a long time.” Just imagine this – empathizing with the mind of an insect! That, for me, ladies and gentlemen, is the pinnacle of empathy!