The epistemic harms of empathy in phenomenological psychopathology

Abstract

Jaspers identifies empathic understanding as an essential tool for grasping not the mere psychic content of the condition at hand, but the lived experience of the patient. This method then serves as the basis for the phenomenological investigation into the psychiatric condition known as ‘Phenomenological Psychopathology’. In recent years, scholars in the field of phenomenological psychopathology have attempted to refine the concept of empathic understanding for its use in contemporary clinical encounters. Most notably, we have Stanghellini’s contribution of ‘second-order’ empathy and Ratcliffe’s ‘radical empathy’. Through this paper, we reject the pursuit of a renewed version of ‘empathic understanding’, on the grounds that the concept is fundamentally epistemically flawed. We argue that ‘empathic understanding’ risks (1) error, leading to misdiagnosis, mistreatment and an overall misunderstanding of the experience at hand, (2) a unique form of epistemic harm that we call ‘epistemic co-opting’ and (3) epistemic objectification. To conclude, we propose that empathic understanding ought to be replaced with a phenomenological account of Fricker’s virtuous listening.

Examination of self patterns: framing an alternative phenomenological interview for use in mental health research and clinical practice

“…Failure to recognize these issues may lead phenomenological researchers to “extract” a decontextualized utterance from the text in a way that risks distorting participants’ experiences to justify and support, for instance, psychopathological claims or theories ( Stanier, 2022 ). This may increase the risks of epistemic harms such as those described by Spencer and Broome in relation to certain contemporary forms of empathic understanding in psychiatric research and include risks of error “leading to an overall misunderstanding of the experience at hand, and epistemic injustice through co-opting the patient’s experience and intellectual arrogance and epistemic objectification” ( Spencer and Broome, 2023 ).…”

“…This focus comes at the expense of more situated investigations that consider factors such as world events, personal meanings, painful affect, interpersonal, cultural, and intersectional aspects of self-experience, normative factors, autobiographical narratives, social and historical conditions affecting the emergence of psychopathology. In response to this, there have been calls to develop new, ethically responsive and engaged phenomenological approaches to explore the embedded and situated quality of psychopathology ( Kirmayer, 2015 ; Ritunnano, 2022 ; Stanier, 2022 ; Pienkos et al, 2023 ; Spencer and Broome, 2023 ). These approaches give attention to the personal, agentive, interpersonal, and socio-cultural factors that shape the experience of mental illness or disability.…”