Welcome back to the Fabiah Blog series, EI and Nursing! This time we cover sympathy vs empathy as well as compassion. Next time, in our final article of the series, we will see one more surprising way that EI helps nurses.
What if, by saying something nice, we made a patient feel worse? What if phrases like “It’s alright,” and “You won’t even miss your hair,” and “You’re just the strongest person,” were exactly what they did not want to hear?
That’s exactly what a 2017 study found. Shane Sinclair and Kate
Beamer asked palliative cancer patients about the responses people had to their suffering. The patients described one category of response that was unhelpful, unwanted, and even made them feel worse. And those “nice” phrases mentioned above fall right into that undesirable kind of response. If these are unwanted responses, then why do we say them? And, what should we say instead? As we delve into these questions, recall what we’ve learned about Emotional Intelligence (EI) and empathetic listening. Both will help us make sense of the results of this study.
Sinclair and Beamer found patients making a distinction between responses that expressed sympathy vs empathy.
Of sympathy, one patient said, “Sympathy is very easy, it’s an emotion, probably one of the easiest emotions to fake. I hate sympathy!”
According to patients sympathy is:
From the patients’ point of view, a sympathetic response was a distancing response. By expressing sympathy, a person kept the patient’s suffering at arm’s length.
Sympathetic responses often included mitigation of suffering – “It’s not so bad.” – or shifting focus – “You should think about the good things.” Patients noticed people used this distance for self-protection. By rebuffing difficult feelings like grief and fear, sympathy protected people from coming too close to the patients’ suffering, but left patients feeling alone and discouraged.
Empathy was given an almost opposite profile. Patients described empathy as being:
Empathetic responses were marked by the attempt to connect with a patient’s suffering. Rather than protect themselves with quick and shallow responses, people who expressed empathy adjusted their attitudes and emotions to be more aligned with the patient. The patient’s emotion was given priority.
Of empathy, one patient reported, “Empathy enters into another’s suffering … it’s just the ability to be there.”
Connections to the sympathy/empathy distinction have appeared throughout the EI and Nursing series. For example, we saw that empathetic listening is the effort to understand and connect with another person, which is exactly what distinguishes empathy from sympathy. Or consider Emotional Intelligence, by which we correctly identify and effectively manage emotion; Sinclair and Beamer found that a person’s inability to process a patient’s suffering is what leads them to express sympathy instead of empathy. We could say that sympathy is stuck in the attention phase of EI, where we have a general awareness that something is wrong, we feel distress, but can’t get any further. Without moving on to the clarity and repair phases of EI, we’re left with the knee-jerk reaction of sympathy.
Above we gave sympathy three markers and empathy only two. Why didn’t we describe empathy as helpful the way we described sympathy as unhelpful?
Because patients in Sinclair and Beamer’s study used a third word to describe a response that both connected with their suffering and looked for some way to help. The word they used was compassion. Whereas empathy might listen and connect but do nothing further, compassion wants to find something to do to alleviate patients’ suffering.
So, now we can say why those nice sounding phrases can make a patient feel worse. In sympathetic responses, patients sense a desire to disconnect, which leaves them alone with their suffering. So why do we sometimes express sympathy instead of empathy? Because sympathy protects us, because we’re thinking of ourselves. It’s the same barrier we covered last time, standing in the way of empathetic listening. On the positive side, the three strategies we covered in the previous article apply here as well. In place of sympathy we can ask questions that lead to connection, like “What are you feeling?” We can reflect: “You seem frustrated with your options.” And, we can help: “Is there some way I can make things better for you?”
If we put into practice all we’ve learned in this series, we should find ourselves moving more and more from sympathy to empathy and, lastly, into compassionate care.
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