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 Table of Contents  
Year : 2021  |  Volume : 7  |  Issue : 1  |  Page : 1-2

Empathy in clinical practice

Department of Psychiatry, PIMS, Karimnagar, Telangana, India

Date of Submission18-Jun-2021
Date of Decision19-Jun-2021
Date of Acceptance19-Jun-2021
Date of Web Publication18-Jul-2021

Correspondence Address:
Dr. Sai Krishna Puli
Department of Psychiatry, PIMS, Karimnagar, Telangana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjp.tjp_26_21

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How to cite this article:
Puli SK. Empathy in clinical practice. Telangana J Psychiatry 2021;7:1-2

How to cite this URL:
Puli SK. Empathy in clinical practice. Telangana J Psychiatry [serial online] 2021 [cited 2022 Jan 17];7:1-2. Available from: http://www.:tjpipstsb.org/text.asp?2021/7/1/1/321771

In day-to-day clinical practice, a therapeutic relationship is of paramount and a complex phenomenon, where multiple factors interlace with each other to have a desired outcome. Among those factors, empathy is a prime factor for better outcome. A doctor's ability to establish an empathetic understanding of their patient's situation is essential in the development of a therapeutic relationship. This relationship is vital for effective practice of modern medicine.

Currently, we are living in a technical world where evidence-based medicine and statistics decide the treatment protocols. The core importance of the therapeutic relationship is de-emphasized.[1]

Empathy was first used in the English language by Edward Titchener in 1909.[2] It is derived from the German word Einfuhlung, which is a term from esthetics, approximately meaning “to feel into an object.” Lipps described the concept as “the experience of another human.”[3] Coulehan et al. defined empathy as “the ability to understand the patient's situation, perspective, and feelings and to be able to communicate that understanding to the patient.”[4]

A systematic review of the literature on the effects of empathy concluded that “empathy is an important factor in patient's satisfaction and adherence, in decreasing patient's anxiety and distress, in better diagnostic and clinical outcomes, and in strengthening patient enablement.”[5]

Mental health disorders directly interfere with an individual's willingness to seek help, forming trusting relationships, and ability to communicate logically as well as emotionally. Many academicians have written that psychiatry is losing its way as a clinical and academic discipline by overemphasizing medications as treatment.[6],[7]

  Carl Rogers Concept on Empathy Top

Carl Rogers defined empathy as “to perceive the internal frame of reference of another with accuracy, and with emotional components which pertain thereto, as if one were the other person, but without ever losing the 'as if' condition.” Rogers felt that making a diagnosis is counter-therapeutic and empathetic understanding is therapeutic in itself.[8] Barett-Lennard describes an “empathy cycle” in which a therapist listens openly to the patient; the therapist resonates with that experience; the therapist expresses resonance back; and then, the patient becomes aware of being understood and continues to express her or himself with a heightened level of comfort.[9]

  The Latest Evidence: Empathy Neurons Top

With the recent evolution of neurobiology, mirror neurons in the prefrontal cortex are believed to exist to facilitate empathetic resonance with others.[10] Recent neurobiological attachment models of interpersonal interaction and affect regulation concluded that empathy is regulated by right sided brain structures.[9]

  Indian Psychiatry - Guru'S Concept Top

My understanding of empathy was from my Guru than from a traditional textbook which I want to share with my colleagues. This was by closely observing his way of dealing with patients, family members, and psychotherapy sessions based on Indian concepts.

Empathy has different definitions that cover a broad range of emotional states, including caring for other people and having a desire to help them, as well as experiencing emotions as if placing a doctor's feet into the patient's (”client”) shoes. It is also the ability to feel and share the emotions of others.

The basic capacity to recognize emotions is probably innate, but it can be cultivated and achieved with various degrees of intensity and accuracy. Some can adequately develop their empathy to an altruistic level where the doctor evolves into God.

This level probably equals to vaidyonarayanohari, a well-known Indian saying. At this highest level, a doctor can see, the “being” in every being, whether human or animal, irrespective of their illness or wellness domain. The purpose of doctor-patient consultation is not for mere symptom treatment but to diagnose level of well-beingness and disorders.[11]

  Conclusion Top

Empathy is one of the key factors in successful clinical practice. Empathy should be taught to all medical students, residents, nurses, and paramedical staff working in the healthcare industry. They should be explained why empathy is important in strategizing treatment plans. Role playing of clinical scenarios, various clinical practical methods to improve patient interactions should be part of their training programs. Nowadays, we are observing barbaric attacks on healthcare workers which can be minimized by empathetic communication with the patients and family members.

  References Top

Eby D. Empathy in general practice: Its meaning for patients and doctors. Br J Gen Pract. 2018;68:412-3.  Back to cited text no. 1
Stueber K. Empathy. In: The Stanford Encyclopedia of Philosophy. Stanford: Spring; 2018. Available from: https://plato.stanford.edu/archives/spr2018/entries/empathy/. [Last accessed on 2018 Aug 06].  Back to cited text no. 2
Lipps T. Aesthetik. Vol. 2. [In German]. Hamburg: Voss Verlag; 1905.  Back to cited text no. 3
Coulehan JL, Platt FW, Egener B, Frankel R, Lin CT, Lown B, et al. “Let me see if i have this right.”: Words that help build empathy. Ann Intern Med 2001;135:221-7.  Back to cited text no. 4
Derksen F, Bensing J, Lagro-Janssen A. Effectiveness of empathy in general practice: A systematic review. Br J Gen Pract 2013;63:e76-84.  Back to cited text no. 5
Bracken P, Thomas P, Timimi S, Asen E, Behr G, Beuster C, et al. Psychiatry beyond the current paradigm. Br J Psychiatry 2012;201:430-4.  Back to cited text no. 6
Kleinman A. Rebalancing academic psychiatry: Why it needs to happen - And soon. Br J Psychiatry 2012;201:421-2.  Back to cited text no. 7
Tudor K. Understanding empathy. Transactional Anal J 2011;41:39-57.  Back to cited text no. 8
Schore AN. The right brain is dominant in psychotherapy. Psychotherapy (Chic) 2014;51:388-97.  Back to cited text no. 9
Young A. Empathy, evolution and human nature. In: Decety J, editors. Empathy from Bench to Bedside. MIT Press, One Rogers Street, Cambridge, Ma 02142-1209; 2012. p. 21-37.  Back to cited text no. 10
Kishan P. Yoga and spirituality in mental health: Illness to wellness. Indian J Psychol Med 2020;42:411-20.  Back to cited text no. 11


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