Encouraging perspective taking: Using narrative writing to induce empathy for others engaging in negative health behaviors

Abstract

Societal expectations of self-care and responsible actions toward others may produce bias against those who engage in perceived self-harming behavior. This is especially true for health professionals, who have dedicated themselves to helping reduce the burden of illness and suffering. Research has shown that writing narratives can increase perspective taking and empathy toward other people, which may engender more positive attitudes. Two studies examined whether creating a fictional narrative about a woman who smokes cigarettes while pregnant could increase positive attitudes toward the woman who smokes and reduce the internal attributions made for her behavior. Across both experiments, the narrative writing intervention increased participants’ empathy and perspective taking, evoked more positive attitudes toward a woman who smokes cigarettes while pregnant, and increased external attributions for her behavior. This work supports our hypothesis that narrative writing would be an efficacious intervention promoting attitude change toward patients who engage in unhealthy, and often contentious, behaviors. This work also suggests that narrative writing could be a useful intervention for medical professionals and policy makers leading to more informed policy or treatment recommendations, encouraging empathy for patients, and engendering a stronger consideration of how external forces can play a role in someone’s seemingly irresponsible behavior.

The impact of narrative writing on empathy, perspective-taking, and attitude: Two randomized controlled experiments on violations of Covid-19 protection regulations

“…As expected, empathy and attitude toward the fictional person changed more positively in the experimental group than in the control group. Contrary to the hypotheses and in contrast to the results of Shaffer and colleagues [35], no stronger change in perspective-taking was found in the experimental group compared to the control group. Regarding attribution, the pattern of results was mixed-the result of Shaffer and colleagues [35] was replicated in only one case (Study 2, attribution item 3).…”

“…Shaffer and colleagues [35] used the fictional scenario of seeing a pregnant woman smoking a cigarette in a parking lot in front of a supermarket. The studies presented here aimed at replicating and extending the findings of Shaffer and colleagues [35] by using typical situations where people show adverse health behavior in the context of the current Covid-19 pandemic, and in doing so exhibit behavior that may also be potentially harmful to the health of others.…”

“…The SPF is the German version of the Interpersonal Reactivity Index (IRI) [37], consisting of the four subscales perspective-taking, empathic concern, fantasy, and personal distress. As in the study by Shaffer and colleagues [35], we used only the subscales perspective-taking and empathic concern. The four perspective-taking subscale items measure the ability to cognitively put oneself in the other person's position, while the four items of the empathic concern subscale measure emotional involvement in the feelings of others.…”

“…Attribution was measured with three single items (see Table 2), following the procedure used by Shaffer and colleagues [35]. Participants were again asked to indicate their agreement with the statements on a scale from "not at all" (0) to "very much" (100).…”

‘Attorneys of the poor’: Training physicians to tackle health inequalities

“…51 Medical humanities, including fiction reading and writing, can develop cultural competence, and insight into patient experience. 52,53 Medical schools are constantly required to 'modernise' and expand an ever-congested curriculum, while protecting the teaching of traditional core clinical skills and knowledge required for the safe practice of new doctors. Some call for the undergraduate medical curriculum to remain focused solely on knowledge-based teaching, and that extraneous elements detract from training safe doctors.…”