Towards a relational conceptualization of empathy

Abstract

Empathy is a fundamental concept in health care and nursing. In academic literature, it has been primarily defined as a personal ability, act or experience. The relational dimensions of empathy have received far less attention. In our view, individualistic conceptualizations are restricted and do not adequately reflect the practice of empathy in daily care. We argue that a relational conceptualization of empathy contributes to a more realistic, nuanced and deeper understanding of the functions and limitations of empathy in professional care practices. In this article, we explore the relational aspects of empathy, drawing on sources that offer a relational approach, such as the field of care ethics, the phenomenology of Edith Stein and qualitative research into interpersonal and interactive empathy. We analyse the relational aspects of three prevalent components of empathy definitions: the underlying ability or act (i.e. the cognitive, affective and perception abilities that enable empathy); the resulting experience (i.e. empathic understanding and affective responsivity) and the expression of this experience (i.e. empathic expression). Ultimately, we propose four inter‐related understandings of empathy: (a) A co‐creative practice based on the abilities and activities of both the empathizer and the empathee; (b) A fundamentally other‐oriented experience; (c) A dynamic, interactive process in which empathizer and empathee influence each other's experiences; (d) A quality of relationships .

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

“…Jolanda van Dijke, Inge van Nistelrooij, Pien Bos, and Joachim Duyndam (2020) share similar concerns to Morgan, which they address from a slightly different angle. Rather than arguing for a hybrid approach in which basic empathy is supplemented with higher-level cognitive processes, such as narrative interventions, they stress the relational aspects of empathic engagement.…”

“…It also requires that one appreciate the particularity, even the uniqueness, of their experience and subjectivity. Some healthcare researchers have drawn on the phenomenological concept of basic empathy in order to understand not only how to see patients as more than biological bodies, but also how to see them as unique individuals with specific sets of desires and needs (Morgan 2017; van Dijke et al 2020).…”

“…However, what we perceive him as expressing also depends on his own expressive skills and capacities. They say, "When patients fail to express themselves, caregivers may still empathize with their patients' situation, but the inner world of experiences and meanings remains hidden" (van Dijke et al 2020). Drawing on the work of care ethicist Nel Noddings (2013), van Dijke and her colleagues argue that the empathizer and the empathee have differing, but complementary, obligations in the caring encounter.…”

“…By thinking of empathy in this relational way, we are better able to identify some of the challenges to accurate and effective empathy. A lack of trust may, for instance, undermine one's ability to accurately know the other's experience (van Dijke et al 2020;Reynolds and Scott 2000). On the one hand, an empathee who doesn't trust a potential empathizer may be less likely to exhibit expressive behavior.…”

Creating an ethical culture to support recovery from substance use disorders

“… 39 This raises questions over whether it is possible to accurately know other peoples’ experience. van Dijke et al 41 note that empathy has been rejected as a form of projection that does not really help us understand the experience of others. However, even if we do not reject the possibility of empathising with others, ethical questions remain.…”