by Sherry F. Colb
In my Verdict column this week, I discuss a recently-published study about empathy and people suffering from mental disorders. The study found that mental health care providers experienced greater empathy in response to (hypothetical) patients whose mental health symptoms were explained by psychosocial factors (i.e., life experiences such as trauma) and less empathy in response to patients (with the same symptoms) whose symptoms were explained by biological factors (such as genetics). In my column, I attempt to make sense of these findings, especially in light of the seemingly contradictory fact that juries in insanity cases are more likely to acquit when the defendant presents biological explanations for his mental illness.
In this post, I want to talk a bit about empathy more generally and why people do and do not feel empathy in response to others. Part of what I think happens in the case of the clinicians in the study is that they feel greater empathy for people who appear to be "just like everyone" (and therefore just like the therapists) but who have encountered life situations that caused the tremendous suffering that brought them to the clinicians' offices. One factor in empathy, then, is a perceived similarity between the object of one's empathy and oneself. Someone who is different enough from the rest of us may simply fail to trigger the sense of "oneness" that leads us to empathize.
A potential empathy-blocker, however, can come from the same direction as empathy triggers ordinarily do. A perceived similarity can, instead of generating a positive identification that yields empathy, induce anxiety that "this could be me instead of him or her!" If a person comes to us seeking empathy, and the person is very much like us and fell upon hard times that could easily fall upon us as well, it may feel safest to distance ourselves from that person and thus from the accompanying dread that we could find ourselves in that person's shoes. This may not be much of an issue for therapists, but it could play a role in how most of us think about people we know as well as people we do not know but whose lives may be affected by our actions or political policies that we put into place. Another way of saying this is that when someone who is suffering seems to resemble us in too many ways, it may be tempting to distance ourselves from that someone and to construct ways in which we are simply "nothing like" the person whose predicament we are considering.
This sort of distancing process might explain why many of us look at a homeless person on the street and make a variety of assumptions that help distance ourselves from that person. We might assume that the person is mentally deranged in a way that we would never be, or we might conclude that he was simply unwilling to work or to apply his skills. Learning that he actually has an advanced degree and used to hold a responsible and demanding job might make many of us feel very uncomfortable. If he could end up in that situation, then what's to stop us from also finding ourselves homeless? It may be, then, that our tendency to create distance or "blame the victim" when someone similar to us winds up in a terrible situation is an effort to create precisely the distance that, in other contexts, lead clinicians not to empathize with patients with biological (rather than psychosocial) explanations for their mental illnesses. In this sense, we may truly know at some level that distance reduces identification and empathy, and we accordingly (though perhaps subconsciously) strive to distance ourselves from those who really do resemble us but whose suffering might yield discomfort and fear.
I am not sure what prescription these observations provide. If people are inclined to distance themselves as a self-preservation measure, then perhaps calling their attention to the phenomenon will do little stop it. If I know that I am creating boundaries between me and someone else who is suffering in order to spare myself the fear of becoming like the other person, this knowledge might give me more reason to leave those boundaries firmly in place. On the other hand, perhaps an awareness of the process--and a consciousness of the fact that we too may some day need to be on the receiving end of others' empathy--can help us to expand our willingness to empathize and thereby enrich one anothers' lives. Boundaries do not truly protect us (since whatever anxiety the other person triggers is likely there in our minds already anyway), yet boundaries isolate us from one another. And feeling others' pain allows us to feel their joy as well, especially if our empathy can play a role in healing what ails them.