Empathy is a complex psychological process that allows us to form bonds with other people. Through empathy, we cry when our friends go through hard times, celebrate their successes, and rage during their times of hardship. Empathy also allows us to feel guilt, shame, and embarrassment, as well as understand jokes and sarcasm.
Empathy is the capacity to understand or feel what another person is experiencing from within their frame of reference, that is, the capacity to place oneself in another’s position. Definitions of empathy encompass a broad range of social, cognitive, and emotional processes primarily concerned with understanding others (and others’ emotions in particular). Types of empathy include cognitive empathy, emotional (or affective) empathy, somatic empathy, and spiritual empathy
In this article, we explore empathy, its benefits, and useful ways to measure it. We also look at empathy fatigue – a common experience among clinicians and people in the caring professions – and provide beneficial resources.
What Is Empathy in Psychology?
In psychology, empathy is loosely defined as an ability to understand and experience someone else’s feelings and to adopt someone else’s viewpoint (Colman, 2015). The term ‘empathy’ comes from the German word Einfuhlung, which means “projecting into” (Ganczarek, Hünefeldt, & Belardinelli, 2018) and may explain why empathy is considered the ability to place yourself in someone else’s shoes.
Classification
Empathy has two major components:
- Affective empathy, also called emotional empathy, is the ability to respond with an appropriate emotion to another’s mental state. Our ability to empathize emotionally is based on emotional contagion: being affected by another’s emotional or arousal state.[rx] Affective empathy can be subdivided into the following scales:[rx][rx]
- Empathic concern: sympathy and compassion for others in response to their suffering.
- Personal distress: feelings of discomfort and anxiety in response to another’s suffering. There is no consensus regarding whether personal distress is a form of empathy or instead something distinct from empathy. There may be a developmental aspect to this subdivision. Infants respond to the distress of others by getting distressed themselves; only when they are two years old do they start to respond in other-oriented ways: trying to help, comfort, and share.[rx]
- Cognitive empathy is the ability to understand another’s perspective or mental state. The terms social cognition, perspective-taking, theory of mind, and mentalizing are often used synonymously, but due to a lack of studies comparing theory of mind with types of empathy, it is unclear whether these are equivalent.[rx] Although measures of cognitive empathy include self-report questionnaires and behavioral measures, a 2019 meta-analysis [rx] found only a negligible association between self-report and behavioral measures, suggesting that people are generally not able to accurately assess their cognitive empathy abilities. Cognitive empathy can be subdivided into the following scales:[rx][rx]
The scientific community has not coalesced around a precise definition of these constructs, but there is consensus about this distinction.[rx] Affective and cognitive empathy are also independent of one another; someone who strongly empathizes emotionally is not necessarily good at understanding another’s perspective.[rx]
3. Compassionate empathy
This incorporates both cognitive and affective empathy by using these two responses to make you want to take action, and so relieve the other person of their suffering.
What is a hyper-empathy syndrome?
Hyper-empathy is the innate ability to be completely connected and in tune with another’s emotions and, subsequently, on high alert towards negative feelings.
In psychotherapist Imi Lo’s article ‘The gift inside borderline personality disorder (BPD)’ published in Counselling Directory, she notes that individuals with a borderline personality disorder often associated with high or hyper-empathy.
“Despite BPD being referred to as a ‘personality disorder’, it is not a character flaw but is best understood as a limitation in a person’s capacity to regulate emotions. This means that the person with BPD often experiences emotions as rapidly changing, or spiraling out of control. These symptoms go alongside impulsive self-soothing behaviors and a chronic sense of internal hollowness.
“Although the link between BPD and empathy remains controversial, many people with BPD identify with the traits of being an ‘empath’ or being hyper-empathic,” says Imi.
Because individuals with BPD can associate with hyper-empathy, they are also likely to experience some form of emotional or empathic distress. A study published in the journal Psychiatry Research in 2015 confirmed this, noting that while there are certainly advantages to empathic abilities, our human bias towards emotional negativity could “carry a risk for empathic distress”.
What is empathy deficit disorder?
On the other end of the scale, lacking the ability to feel, understand, and resonate with another’s feelings is categorized as empathy deficit disorder (EDD). This can result in difficulty forming and maintaining relationships, for both the individual who lacks empathy and potential friends and loved ones. EDD is the term most often used in the UK, yet it’s important to recognize and respect personal preferences around terms individuals may want to use.
Those experiencing EDD may find they have more personal conflicts, breakdowns in communications, or sometimes polarising opinions. This can leave a person feeling isolated, as they struggle to connect and have meaningful relationships with others, due to being focused on their thoughts and feelings and prioritizing them above those around them.
Depending on the cause of empathy deficit disorder, the condition may affect a particular one of the three types of empathy, or it may affect all of them. In general, though, affective empathy – the ability to share another’s feelings – is often impacted more.
The disorder can be prevalent in people on the autism spectrum, as well as certain types of mental health conditions, such as narcissistic and antisocial personality disorders, bipolar disorder, and borderline personality disorders.
Symptoms of empathy deficit disorder
An individual with EDD may exhibit the following behaviors:
- Struggle to make new friends
- Difficulty making emotional connections
- Quick to criticize or dismiss individuals
- Struggle to show appreciation
- Has high levels of expectations in matters regarding themselves
- Focus on themselves and struggles to listen to others
- Lack of understanding that others who feel hurt aren’t the cause of their pain
How can you manage empathy deficit disorder?
The feelings and behaviors associated with personality disorders can be difficult to live with, and everyone deserves understanding and support.
While the solution to managing EDD can depend on the cause behind the condition, for the most part, it requires self-reflection. An Individuals need to recognize for themselves that they have EDD, and choose if, and when, to try a treatment on their terms. Mind-training exercises and mindfulness practice can be useful tools for that next step.
One exercise you could explore is to try to place yourself into the mind of someone you have previously struggled to empathize with. Imagine you are that person and think about all the things that make them a whole being – hopes and dreams, times of hardship, people who love them. Finding things you have in common can help to breach that gap in your viewpoints, so you can better understand where they are coming from.
Difficulties with defining empathy
Defining empathy clearly and exhaustively enough to be studied in psychology is difficult. For example, is empathy the ability to understand or feel or share or interpret someone else’s feelings?
Each of these verbs differs slightly, providing a different meaning to empathy. As a result, the underlying psychological mechanism and part of the brain responsible for empathy also differ.
Part of the difficulty defining empathy is that it comprises multiple components. For example, Hoffman (1987) argued that empathy in children develops across four different stages and that each stage lays down the foundation for the next.
These four stages are:
- Global empathy or ‘emotion contagion,’ where one person’s emotion evokes the same emotional reaction in another person (or the observer).
- Attention to others’ feelings, where the observer is aware of another person’s feelings but doesn’t mirror them.
- Prosocial actions, where the observer is aware of another person’s feelings and behaves in a way to comfort the other person.
- Empathy for another’s life condition, where the observer feels empathy toward someone else’s broader life situation, rather than their immediate situation right at this instance.
Fletcher-Watson and Bird (2020) provide an excellent overview of the challenges associated with defining and studying empathy. They argue that empathy results from a four-step process:
- Step 1: Noticing/observing someone’s emotional state
- Step 2: Correctly interpreting that emotional state
- Step 3: ‘Feeling’ the same emotion
- Step 4: Responding to the emotion
Empathy is not achieved if any of these four steps fail.
This multi-component conception of empathy is echoed across other research. For example, Decety and Cowell (2014) also posit that empathy arises from multiple processes interacting with each other.
These processes are:
- Emotional: The ability to share someone else’s feelings
- Motivational: The need to respond to someone else’s feelings
- Cognitive: The ability to take someone else’s viewpoint
The Empathy Quotient
The terms “empathy,” “Empathy Quotient,” and “emotional intelligence” are often used interchangeably, but they are not the same construct.
Part of this confusion stems from their corresponding definitions.
Empathy is the ability to share someone else’s emotions and perspectives. Emotional intelligence is the ability to understand, interpret, and manage other people’s emotions, as well as your own. This last inclusion – your own emotions – is what distinguishes emotional intelligence from empathy.
The Empathy Quotient is a measurement of empathy (Baron-Cohen & Wheelwright, 2004). It is akin to the Intelligence Quotient (IQ) but is a measure of empathy rather than intelligence. Like IQ, higher scores of the Empathy Quotient are meant to represent higher abilities of empathy.
Importantly, the Empathy Quotient differs from the Emotional Quotient. Emotional Quotient is measured using the BarOn Emotional Quotient-Inventory (Bar-On, 2004) and aims to measure emotional intelligence rather than empathy. It’s easy to confuse them because “EQ” is used to refer to both.
To determine whether the Empathy Quotient is a suitable test of empathy, Baron-Cohen and Wheelwright (2004) administered the measurement to a group of neurotypical people and a group of people diagnosed with Asperger syndrome and compared their scores.
On average, individuals with Asperger syndrome scored significantly lower than neurotypical people. From this study, a score of 30 was determined to be a critical cut-off mark. Scores less than 30 were typically found among the participants with Asperger syndrome. Furthermore, the test-retest reliability of the Empathy Quotient was high, suggesting that the test reliably measures empathy.
7 Real-Life Examples
Since empathy is so complex and involved in so many social interactions, there are many examples of empathy in the real world.
In a discussion with a friend, have you ever felt so moved that you experienced the same emotion that they did? Or maybe a friend shared a cringe-worthy story of sheer humiliation, and that feeling was mirrored in you.
These situations when you experienced the same emotions as your friends are examples of empathy. Other examples of empathy include understanding someone else’s point of view during an argument, feeling guilty when you realize why someone might have misunderstood what you said, or realizing something you said was a faux pas. These scenarios require you to take someone else’s viewpoint.
Some of the best examples of empathy can be found in the work by Oliver Sacks and Atul Gawande. Sacks was a neurologist who had a profound impact through his thoughtful, patient-driven books on the field of psychiatry and neuropsychology.
Atul Gawande is a surgeon who worked with the World Health Organization and has published several books on improving healthcare and healthcare systems. Both authors address their patients in a sensitive, thoughtful manner that evokes a lot of empathy in the reader.
Is It Important? 3+ Benefits of Empathy
We do not exist in a vacuum.
We participate in many scenarios in which we convey and receive information with other people, verbally and nonverbally.
Regardless of whether or not these interactions are important, we have to perceive, interpret, and respond to numerous cues.
Empathy is more than ‘just’ the ability to feel what someone else is feeling. Empathy is an essential skill that allows us to effectively engage with other people in social contexts (Baron-Cohen & Wheelwright, 2004).
Without empathy, we would struggle to:
- understand other people’s feelings, motivations, and behaviors;
- respond appropriately to someone else’s feelings; and
- understand social interactions that rely on subtle behaviors, cues, and social norms, such as jokes, faux pas, and sarcasm.
The ability to respond appropriately to someone else’s emotions is extremely important for forming bonds. Empathy underlines the bond that forms between parent and child (Decety & Cowell, 2014).
Some researchers even consider some aspects of empathy to be a defining feature of humans. Our ability to consider another person’s viewpoint is considered uniquely human (Decety & Cowell, 2014).
Jean Decety and Jason Cowell (2014) argue that empathy is one process that contributes to understanding and engaging in complex social behavior, such as prosocial behavior, which includes volunteering as well as providing care for people who are terminally ill.
Earlier in this article, we mentioned the studies by Baron-Cohen and Wheelwright (2004) in which they compared Empathy Quotient scores between people with Asperger syndrome and neurotypical people.
People on the autism–Asperger spectrum are believed to have a diminished capacity for empathy and, as a result, struggle with social contexts. However, their lower empathy scores do not mean that they are without feeling or should be considered psychopaths (who also have lower scores of empathy).
People on the autism spectrum often report that their intention is not to hurt other people’s feelings, and they feel guilty if they caused someone else’s hurt feelings (Baron-Cohen & Wheelwright, 2004).
Furthermore, people on the autism spectrum often report that they want human connections; however, they struggle to make them because they are not aware of how their behavior affects how other people perceive them (Baron-Cohen & Wheelwright, 2004). This shows how important empathy is in developing relationships and interpreting subtle social cues.
Empathy vs Sympathy and Compassion
The three terms – empathy, sympathy, and compassion – are often confused with each other, because they are often used when referring to someone else’s feelings. For example, in response to a friend’s bad news, do you feel empathy, sympathy, or compassion? The terms are used in similar contexts, but they refer to different behaviors.
- From the definitions provided above, empathy involves interpreting, understanding, feeling, and acting on other people’s feelings. Empathy is a multidimensional process and relies on affective, cognitive, behavioral, and moral components (Jeffrey, 2016). Remember, empathy is the ability to adopt someone else’s viewpoint or to put yourself into someone else’s shoes.
- Sympathy is the feeling of pity for someone else’s misfortune or circumstances.
- Compassion is the desire and act of wanting to alleviate someone else’s suffering. Compassion includes the affective components of empathy and sympathy, but it is accompanied by an action to change the circumstances of the person who is suffering (Sinclair et al., 2017). A compassionate act can also result in our suffering alongside the other person; this is referred to as co-suffering. Compassion is also linked to altruistic behavior (Jeffrey, 2016).
Examples of Empathy vs Sympathy vs Compassion
To further cement the difference between these three terms, consider the following examples:
Emma relays a recent event where she was extremely embarrassed. As she retells the story, her friend, Tamika, groans and mutters “Oh my word, I would feel so embarrassed. I would want the world to swallow me whole!”
In this example, Tamika doesn’t actually want to disappear into a hole. Instead, she’s correctly understanding and interpreting the situation that Emma found herself in. She is most likely experiencing empathy for Emma’s situation. She is not feeling pity, nor is she acting compassionately.
Jerome’s mother recently suffered a near-fatal heart attack. He listens to his mother retell her sisters about her experience. As she recounts her experience, she starts crying, because she was so afraid, and she realized that she might never see her loved ones again. Jerome starts crying as he listens to his mother.
In this example, Jerome is feeling sympathy (pity) for his mother and what she went through.
On his route to university, Jamal sees the same homeless man every day. The homeless man sits in the same place, regardless of the weather, with a sign next to him that asks for assistance. Jamal decides to donate some of his clothing to the homeless man.
Jamal’s behavior is an act of compassion. By donating his clothing, he is trying to alleviate the homeless man’s suffering. He may also be experiencing sympathy towards the man, but the act of trying to change the man’s situation is an act of compassion.
Assessing Empathy: 4 Helpful Questionnaires
Use these questionnaires to determine your current level of empathy.
Empathy Quotient
The Empathy Quotient, including the entire questionnaire, its psychometric properties, and the scoring, is described in the original paper by Baron-Cohen and Wheelwright (2004). Professor Simon Baron-Cohen works with the Autism Research Centre (ARC), and the 60-item Empathy Quotient, as well as the scoring matrix, is available from the ARC website.
The Empathy Questionnaire (EmQue)
The Empathy Questionnaire (EmQue), designed by Rieffe, Ketelaar, and Wiefferink (2010), measures empathy in young children (average age of around 30 months) and reflects Hoffman’s (1987) theory of how empathy developed in children.
The questionnaire comprises three subscales, which map onto the first three stages of empathy development posited by Hoffman (1987). The questionnaire correlates well with other measures that aim to capture similar constructs.
The Empathy Questionnaire for Children and Adolescents (EmQue-CA)
A similar version of the EmQue also exists for older children. This version is known as the Empathy Questionnaire for Children and Adolescents (EmQue-CA; Overgaauw, Rieffe, Broekhof, Crone, & Güroğlu, 2017).
Unlike the EmQue, the EmQue-CA is a self-report measure. In other words, the adolescents and children must answer how much they agree with each statement, rather than their parents observing their behaviors.
The final version of the EmQue-CA measures the following three subscales: affective empathy, cognitive empathy, and intention to comfort.
The Toronto Empathy Questionnaire (TEQ)
The Toronto Empathy Questionnaire (TEQ) was developed by refining a collection of questionnaires that measure empathy into a core set of questions (Spreng, McKinnon, Mar, & Levine, 2009).
Researchers collected questions from multiple empathy questionnaires, administered these questions to a large sample of students, and then using exploratory factor analysis, refined the questions to a core set of 16.
The questionnaire and scoring rules are described in the appendix of the original paper (Spreng et al., 2009), which can be accessed on the Measurement Instrument Database for the Social Sciences.
Finally, the TEQ and the Empathy Quotient have a strong, positive correlation, confirming that the questions in both measures the same psychological construct.
A Note on Empathy Fatigue
Feeling empathy is a very useful skill, especially for health professionals such as clinicians, therapists, and psychologists. But the ability to feel empathy for other people comes at the cost of empathy fatigue.
Empathy fatigue refers to the feeling of exhaustion that health professionals experience in response to constantly revisiting their emotional wounds through their clients’ experience (Stebnicki, 2000). For example, a therapist whose client is going through bereavement may be reminded of their own grief and trauma.
By being emotionally available for their client through emotional and stressful periods, the therapist experiences fatigue at a psychological, emotional, and physiological level (Stebnicki, 2000).
Besides manifesting as a sense of fatigue, we can consider empathy fatigue as a form of re-trauma, and as a result, the symptoms resemble that of secondary traumatic stress disorder.
Empathy fatigue in the clinical domain is also referred to as ‘counselor impairment’ because the clinician’s ability to perform their job is impaired (Stebnicki, 2007). An outcome of empathy fatigue is burnout, with particularly sudden onset (Stebnicki, 2000).
Stebnicki (2007) provides a comprehensive list of strategies that clinicians can use to prevent empathy fatigue:
- Self-awareness of the symptoms of empathy fatigue
- Self-care strategies and lifestyle behaviors that protect the clinician from empathy fatigue
- Using a support group and supervisor during periods of empathy fatigue
Finally, PositivePsychology.com’s post detailing self-care for therapists can be easily adapted to other industries. For example, these tips could be incorporated into a wellness session in the workplace to help prevent empathy fatigue.
A Take-Home Message
If we show a little tolerance and humility, and if we are willing to stand in the other person’s shoes — as my mom would say — just for a moment, stand in their shoes. Because here’s the thing about life: there’s no accounting for what fate will deal you. Some days, when you need a hand. There are other days when we’re called to lend a hand.
U.S. President Joseph R. Biden, Jr., Inauguration speech
And that is what empathy is: being able to put yourself in someone else’s shoes. Humans are social creatures, and empathy is an important skill. Without empathy, we will struggle to connect and form bonds. Underdeveloped empathy results in awkward social interactions, which can also weaken social bonds.
No man is an island, entire of itself; every man is a piece of the continent, a part of the main.
John Donne
By connecting, understanding, and having empathy, we can all stand together, lend a hand when needed, and be given a hand when we, in turn, may need it.
