One of the key factors in any successful therapeutic relationship is the ability for the therapist to understand the patient; it is only then authentic safety and healing can occur. Regardless of one’s theoretical orientation or how one comes to understand psychopathology, this key ingredient makes the treatment effective. To gain a better understand of what empathy is, I think it fruitful to turn to the psychoanalyst Heinz Kohut on how he describes this important part of psychotherapy. Empathy is, “the capacity to think and feel oneself into the inner life of another person” (Kohut, 1984). In his understanding, you are not sympathizing (which means feeling or agreeing with a sentiment or opinion) but instead you are taking a risk to be with someone in their happiness, pain, suffering, joy and all the complex emotions that make us human. Empathy is emotional survival.

I have found in my work with patients, this is the single most important factor in relationship to “successful” treatment. What I am talking about is more about than symptom reduction and improving one’s relationships, I am talking about a deeper understanding of one’s self and how they view the world and the people in their lives. It is the job of both the therapist and patient to bridge a new understanding on how they see themselves and the outside world.

 An example that comes to mind is when I worked in an psychiatric in-patient hospital with patients who had schizophrenia. The definition of this word involves two parts; one is “spilt” which is experienced by the person who has difficulty integrating their internal and outside worlds and the second part is “mind.” People who have this diagnosis often find it difficult not only to function within reality, but also form relationships with other people. When I worked with clients who had this painful diagnosis, I found the most beneficial thing I could do is just sit with them and listen. Listen to not only the negative or persecutory thoughts and beliefs, but the glimpses of their own reality and how scary it can be. People who have schizophrenia are often afraid of others due to various reasons. Whether they are delusions, hallucinations or other symptoms that impact relationships, most of all, these people fail to be understood on a societal and individual level. Symptoms, behaviors, dysfunctional patterns of relating to others, are viewed as the problem, but perhaps another way to view these actions are someone trying to protect themselves from how frightening the world can be, an experience we have all had in our lives.

Empathy is vulnerability at its core. In order to be empathic with someone else, you must first open yourself up to another person’s world. This is a great risk because the reality is the other person will start to see your inner world and the parts we are often afraid to express.

Being a good therapist is more than understanding what our patients are going through, it is taking a risk and being with them during their difficult times. It may feel lonely, restless, sad, depressed, and scary, but I would be remiss if I did not say that it can also be joyful, exciting, grateful, and happiness. Empathy is humanity.