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TitleAgainst Empathy: The Case for Rational Compassion
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Total Pages204
Table of Contents
CHAPTER 1       Other People’s Shoes
CHAPTER 2       The Anatomy of Empathy
CHAPTER 3       Doing Good
INTERLUDE      The Politics of Empathy
CHAPTER 4       Intimacy
INTERLUDE      Empathy as the Foundation of Morality
CHAPTER 5       Violence and Cruelty
CHAPTER 6       Age of Reason
About the Author
Also by Paul Bloom
About the Publisher
Document Text Contents
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problems that need to be solved. Freud himself made a similar analogy: “I
cannot advise my colleagues too urgently to model themselves during
psychoanalytic treatment on the surgeon, who puts aside all his feelings, even his
human sympathy, and concentrates his mental forces on the single aim of
performing the operations as skillfully as possible.”

My friend does get into her clients’ heads, of course—she would be useless
if she couldn’t—but she doesn’t feel what they feel. She employs understanding
and caring, not empathy.

I’ve looked so far at the effects of empathy on the empathizer. But what about
those who are empathized with? People in distress plainly want respect,
compassion, kindness, and attention—but do they want empathy? Do they
benefit from it?

A few years ago, my uncle, a man I respected and loved very much, was
undergoing treatment for cancer. While he went to hospitals and rehabilitation
centers, I watched him interact with many doctors and talked to him about what
he thought of them. He appreciated when doctors listened to him and worked to
understand his situation; he resonated to this sort of “cognitive empathy.” He
appreciated as well those doctors who expressed compassion and caring and

But what about the more emotional side of empathy? Here it’s more
complicated. He seemed to get the most from doctors who feel as he did,
who were calm when he was anxious, confident when he was uncertain. And he
was particularly appreciative of certain virtues that have little directly to do with
empathy, such as competence, honesty, professionalism, and certainly respect.

A similar point is made by Leslie Jamison in the opening essay of her
collection, Jamison describes a period in which she worked
as a simulated patient for medical students, rating them on their skills, with one
item being Checklist item 31: “Voiced empathy for my situation/problem.” But
when she draws on her own personal experiences with doctors, she finds herself
more skeptical about empathy’s centrality.

She tells about how she met with a doctor who was cold and unsympathetic
to her concerns, and talks about the pain that it caused her. But she also
describes, with gratitude, another doctor who kept a reassuring distance and
objectivity: “I didn’t need him to be my mother—even for a day—I only needed
him to know what he was doing. . . . His calmness didn’t make me feel
abandoned, it made me feel secure. . . . I wanted to look at him and see the

Page 103

opposite of my fear, not its echo.”
Now I’ve cited both Christine Montross and Leslie Jamison in support of my

arguments for the limits of empathy, but to be fair, both of them also defend
empathy to some degree. After the passage I cited above, where Montross talks
about why she wouldn’t want to feel too much empathy for a patient and why
she wouldn’t want a too-empathic doctor, she steps back a bit: “Still, in most of
the interactions physicians have with patients in everyday medicine—indeed in
my own clinical work—it is easy to see how a reasonable amount of empathy
can be benefi cial, for both parties. Patients feel heard and understood. Doctors
appreciate their patients’ concerns and feel compelled to do as much as possible
to alleviate their suffering.”

And after describing the value of the doctor who kept more of a distance,
Jamison goes on to add: “I appreciated the care of a doctor who didn’t simply
echo my fears. But without empathy, this doctor wouldn’t have been able to
offer the care I ended up appreciating. He needed to inhabit my feelings long
enough to offer an alternative to them and to help dissolve them by offering
information, guidance, and reassurance.”

I agree with a lot of this. It makes sense that concern and understanding are
important. But I think it’s possible to have concern and understanding while
maintaining an emotional distance, without the doctor or therapist having to
“inhabit” the patient’s feelings. I think it’s actually better when this distance is
present, both for the patient and for the doctor.

One might reasonably object that caring just doesn’t work this way. Perhaps
the only way one can truly understand what someone is going through is to feel
what they are feeling. The sort of intellectual understanding that I’ve been
talking about so far just isn’t enough.

When people make this argument, though, I think they are getting distracted
by a different issue. They are compelled by the idea that you can’t truly
understand something without having experienced it yourself. A good therapist,
one might argue, should understand what it’s like to be depressed and anxious
and lonely—and this means that he or she must have at one point felt depressed
and anxious and lonely. These are the sorts of experiences—what Laurie Paul
calls “transformative experiences”—that you have to undergo yourself in order
to know what they’re like. Imagination isn’t enough. There’s just no substitute
for the real thing.

Frank Jackson makes this point through a famous thought experiment (one
expanded upon in the wonderful science fiction/horror movie, .

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AGAINST EMPATHY. Copyright © 2016 by Paul Bloom. All rights reserved under International and Pan-
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