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Consultation Skills

Sympathy, Empathy & Compassion

What is sympathy?

Feelings of pity and sorrow for someone else’s misfortune.  You may not always automatically feel how another is feeling, and that’s when you need to rely on your imagination. You have most likely heard the phrase, “Put yourself in someone else’s shoes.  

Sympathy is a shared feeling, usually of sorrow, pity or compassion for another person. You show concern for another person when you feel sympathy for them. … Empathy is stronger than sympathy. It is the ability to put yourself in the place of another and understand someone else’s feelings by identifying with them.

It makes sense, then, to send sympathy cards when you understand that someone is suffering. You are not feeling that person’s pain, but you want them to know you are aware of their suffering. Typically, people can sympathize much easier than they can empathize

What is empathy?

The ability to understand and share the feelings of another.  Empathy is viscerally feeling what another feels – usually because you have gone through a similar process in your past.  Empathic statements are supportive comments that specifically link the ‘I’ of the doctor and the ‘you’ of the patient. They both name and appreciate the patient’s affect or predicament (Platt and Kelley 1994).  So if you’re in pain and I feel your pain …If you’re being anxious, I pick up your anxiety. If you’re sad and I pick up your sadness.”

Examples

  • I can see that your husband’s memory loss has been very difficult for you to cope with.’
  • I can appreciate how difficult it is for you to talk about this.’
  • I can sense how angry you have been feeling about your illness.’
  • I can see that you have been very upset by hey behaviour.’
  • I can understand that it must be frightening for you to know the pain might keep coming back.’

What is Compassion?

The definition of compassion is the ability to understand the emotional state or concerns of another person or oneself.  You might not necessarily relate to feelings, but you understand the concerns, give them due weight, and want to genuinely help relieve the discomfort because you genuinely care.   So, unlike empathy, compassion has the added element of having a desire to alleviate or reduce the suffering of another.  Thupten Jinpa, Ph.D., is the Dalai Lama’s principal English translator and author of the course Compassion Cultivation Training (CCT). Jinpa posits that compassion is a four-step process:

  1. Awareness of suffering.
  2. Sympathetic concern related to being emotionally moved by suffering.
  3. Wish to see the relief of that suffering.
  4. Responsiveness or readiness to help relieve that suffering.

Still confused?

While these words are near cousins, they are not synonymous with one another.

  • Sympathy means you can understand what the person is feeling but you don’t know what it is like to be in their shoes.    You feel bad, pity or sorrow for them.  Sympathy can be a good tool, but it can also sometimes come across as patronising especially when it fails to provide any sense of support.
    For example “I’m sorry your feel like that”.   “Poor you…”, “I’m so sorry to hear that”
  • Empathy means that you feel what a person is feeling; you know what it is like to be in their shoes.    You needn’t have gone through the process, but it might have been through some vicarious experience.   You can imagine oneself in the situation of another – experiencing the thoughts and emotions of that other person.     None of this can happen without genuine interest and curiosity on your part.
    For example, “I can see how that must have been devastating for you”.  “I can see how difficult it is for you to talk about this.”   “I can see how frustrating that has left you feeling”.
  • Compassion is the willingness to relieve the suffering of another.
 

Why are they important?

All of these things shows the other person that you understand and care about their situation.   Empathy is deeper than sympathy.  Compassion is deeper than Empathy.  However, all three can help deepen the therapeutic relationship between doctor and patient.    These microskills create connection between you and the patient.   They are great ways of instantaneous rapport.   And often, patients in such difficult circumstances aren’t looking for a magic wand to fix everything.   Instead, they simply want to feel that you totally get their point of view and that you are kind to their perspective.   A patient who feels understood is more likely to disclose important information that might actually entirely change a diagnosis or treatment. They’re also more likely to follow the advice you give them.   And in general, you have nicer rewarding consultations where you feel you are making a difference.

So, we said earlier – be careful with sympathy – because it can come across as patronising.
Be careful with empathy – if you are frequently feeling the pain of another (i.e. empathy), you may experience a great deal of burnout and then you will want to run away from it or the patient.   This is a common problem for caregivers and health care providers, and it’s been labelled “empathy fatigue.”  
Compassion, however, is different.  There is nothing to be scared of because it is a renewable invigorating resource. When you have the ability to feel empathy for the other person but then extend a hand to alleviate someone’s pain, you are less likely to burn out.   When you are compassionate, you are happy to want to make the other person’s life better and in doing so, you feel a great sense of self-worth, self-satisfaction and energised.   But remember, the primary aim is about the genuine care and desire to help the other person.    With compassion, you can properly distance yourself form a person’s discomfort and think rationally about what is the best thing to do for their case.
 
The Dalai Lama famously said in the book The Art of Happiness, “If you want others to be happy, practice compassion. If you want to be happy, practice compassion.”

Brene Brown's 4 key steps to showing empaty

  1. Perspective Taking, or putting yourself in someone else’s shoes.
  2. Staying out of judgement and listening.
  3. Recognizing emotion in another person that you have maybe felt before.
  4. Communicating that you can recognize that emotion.
“Gosh, I can see how frightening an experience that must have been for you”

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