Basic empathy: Developing the concept of empathy from the ground up

Abstract

Empathy is a topic of continuous debate in the nursing literature. Many argue that empathy is indispensable to effective nursing practice. Yet others argue that nurses should rather rely on sympathy, compassion, or consolation. However, a more troubling disagreement underlies these debates: There's no consensus on how to define empathy. This lack of consensus is the primary obstacle to a constructive debate over the role and import of empathy in nursing practice.The solution to this problem seems obvious: Nurses need to reach a consensus on the meaning and definition of empathy. But this is easier said than done. Concept analyses, for instance, reveal a profound ambiguity and heterogeneity of the concept of empathy across the nursing literature. Since the term "empathy" is used to refer to a range of perceptual, cognitive, emotional, and behavioral phenomena, the presence of a conceptual ambiguity and heterogeneity is hardly surprising.Our proposal is simple. To move forward, we need to return to the basics. We should develop the concept from the ground up. That is, we should begin by identifying and describing the most fundamental form of empathic experience. Once we identify the most fundamental form of empathy, we will be able to distinguish among the more derivative experiences and behaviors that are addressed by the same name and, ideally, determine the place of these phenomena in the field of nursing. The aim of this article is, consequently, to lay the groundwork for a more coherent concept of empathy and thereby for a more fruitful debate over the role of empathy in nursing.In Part 1, we outline the history of the concept of empathy within nursing, explain why nurses are sometimes warry of adapting concepts from other disciplines, and argue that nurses should distinguish between adapting concepts from applied disciplines and from more theoretical disciplines. In Part 2, we show that the distinction between emotional and cognitive empathy-borrowed from theoretical psychology-has been a major factor in nurses' negative attitudes toward emotional empathy. We argue, however, that both concepts fail to capture the most fundamental form of empathy. In Part 3, we draw on and present some of the seminal studies of empathy that can be found in the work of phenomenological philosophers including Max Scheler, Edmund Husserl, and Edith Stein. In Part 4, we outline how their understanding of empathy may facilitate current debates about empathy's role in nursing.

Empathy in Today’s Health Care Environment

“…They argue that the inherent complexity and heterogeneity of the concept have made it difficult to define through the process of concept analysis. These researchers note that there are different types of empathy, and they advocate for nurses to identify cognitive versus emotional empathy (Fernandez & Zahavi, 2020). Fernandez and Zahavi (2020) believe that while nurses generally have an innate capacity for emotional empathy, they must develop intellectual techniques that allow them to view their patients in an objective manner, which allows them to be therapeutic.…”

“…These researchers note that there are different types of empathy, and they advocate for nurses to identify cognitive versus emotional empathy (Fernandez & Zahavi, 2020). Fernandez and Zahavi (2020) believe that while nurses generally have an innate capacity for emotional empathy, they must develop intellectual techniques that allow them to view their patients in an objective manner, which allows them to be therapeutic. Rather than seeing empathy "as being about identification, fusion, or similarity, basic sympathy must be seen as an experiential engagement with the other that recognizes and preserves the self-other difference" (Fernandez & Zahavi, 2020, p. 4).…”

“…Empathy has been a widely discussed topic in nursing practice, education, and research (Brunero et al, 2010; Fernandez & Zahavi, 2020). Understanding and recognizing this concept is considered essential, and even self-protective, for nursing practice.…”

“…Theoretically, in nursing, there has been ambiguity around the definition of empathy. Fernandez and Zahavi (2020) define empathy as a “range of perceptual, cognitive, emotional, and behavioral phenomena” (p. 1). They argue that the inherent complexity and heterogeneity of the concept have made it difficult to define through the process of concept analysis.…”

“…They argue that the inherent complexity and heterogeneity of the concept have made it difficult to define through the process of concept analysis. These researchers note that there are different types of empathy, and they advocate for nurses to identify cognitive versus emotional empathy (Fernandez & Zahavi, 2020).…”