Am J Psychiatry 1988; 145:420-424
Copyright © 1988 by American Psychiatric Association
Empathy: misconceptions and misuses in psychotherapy
HE Book
Women's College Hospital, Toronto, Ont., Canada.
The frequent misconceptions and misuses of empathy that occur during
psychotherapy are related to confusion about the definition of empathy,
misunderstanding of the difference between the process of empathy and the
therapist's response of being empathic, countertransference exploitation of
empathy to act out the therapist's needs, the therapist's unawareness of
the "layering" phenomenon, and overlooking the patient's level of
self-other differentiation. These misuses result in the patient's feeling
misunderstood and damaged, with a subsequent weakening of the therapeutic
alliance and, at times, a breakdown in self-other differentiation. Once
identified, misuses should be addressed and explored in psychotherapy to
offset disruptions in treatment.
