Empathy's beginnings in psychotherapy and its connection to mindfulness.
Posted Dec 19, 2019
Empathy is an indispensable element of modern psychotherapy, but it only became central to clinical practice after World War II. At this time, the newly established National Institute of Mental Health funded the training of large numbers of clinical psychologists to treat soldiers traumatized by the war. The public eagerly consumed new books, newspaper articles and radio programs on psychology, keen to learn what the science could do for them. And in these years, the revered clinical psychologist Carl Rogers honed his empathic approach in psychotherapy, which soon became popular with a variety of clinicians.
When Rogers identified empathy as a key element of psychotherapy in 1948, it was not a word or concept known to the broader public. Empathy, Rogers explained, entailed a therapist's deep engagement with a client’s experience without judgment or interpretation.
In 1954, Mrs. Oak came for psychotherapy with Rogers, and wondered why it was that parents so often told their children not to cry. She began to cry, and said that the root of her problem was “just being terribly hurt.” Even more painful than the hurt, she said, was that she had “covered it up with so much bitterness. That’s what I want to get rid of! I almost don’t care if I hurt.”
Rogers imagined how she felt and reflected the experience back to her: “You feel that here at the basis of it, as you experienced it, is a feeling of real tears for yourself. But that you can’t show, mustn’t show, so that’s been covered by bitterness that you don’t like.” Once she felt understood, Mrs. Oak could accept her own feelings, triggering the healing process.
Rogers had first implemented this method of reflecting feeling in his treatment interviews with children. He adopted this approach from Jessie Taft and her colleagues at the Pennsylvania School of Social Work. Taft pioneered an emotion-centered therapy based on her background in social psychology and unorthodox psychoanalysis. During therapy sessions, she permitted children to play, explore the room and to express whatever feelings came up. Taft would speak aloud what the child seemed to be feeling in order to bring these emotions into the child’s awareness.
The method of reflecting emotions, Rogers explained in 1948, required empathy, or the adoption of the client’s frame of reference. As a professor of clinical psychology at the University of Chicago, Rogers explained that with empathy, the therapist temporarily stood in the other’s place, “as if one were the other person, but without ever losing the ‘as if’ condition.” Empathy drew on the counselor’s abilities to sense, feel, cognize and imagine the client's experience. “I try to perceive his experience, and the meaning and the feeling and the taste and the flavor it has for him.” When the therapist adeptly reflected the client’s feelings, the client was able to accept them. Accepting rather than trying to change one’s experience unlocked an inner impulse toward growth that Rogers believed existed in each person.
If empathy sounded simple, rarely were individuals able to listen intently to another’s experience without judgment, advice, or analysis. The empathic attitude therefore had to be deliberately cultivated and trained. Rogers listed the empathic adoption of the client’s inner frame of reference as one of the three necessary conditions for psychotherapy, in addition to congruence (the therapist had to be authentic) and unconditional positive regard (the therapist had to have a warm feeling for the client).
After Rogers left academic psychology in 1968, he continued to promote empathy not only as vital to psychotherapy, but as essential for all kinds of relationships. To put aside one’s own concerns for a moment to live in another’s life, “moving about in it delicately without making judgments,” he argued, could dissolve alienation in relationships.
Rogers’ empathic way of being does not neatly map onto the distinction psychologists make today between emotional and cognitive empathy. It does, however, share striking similarities with the concept of empathy promoted in some mindfulness traditions. Ajahn Sucitto, a Theravada Buddhist monk practicing in the Thai Forest tradition, explains how to cultivate empathy for oneself and others by opening to experiences while refraining from fixing, judging or attempting to change them: “In essence it’s just the ability to stand alongside one’s anxiety about what others think, one’s irritation or despond, and to feel with it, rather than get lost in it, shut it off or distract into something else.”
Feeling one’s own experience without getting lost in it is akin to the “as if” condition of empathy described by Rogers. With empathy, one takes on another’s experience as if it were one’s own, but with the continual awareness that the experience is, in fact, someone else’s. Recognizing the difference between oneself and another is a key component of empathy as noted by the neuroscientist Jean Decety: “without self-awareness and emotional-regulation processing, there is no true empathy.”
For Rogers, empathy was the engine of healing in psychotherapy. Accepting one’s own experience or another’s without trying to change it could produce a profound psychological shift. Herein lies empathy's paradox: to embrace an experience just as it is can powerfully transform that experience.
 Carl Rogers & Rosalind Dymond, eds. (1954). The case of Mrs. Oak: A research analysis. Psychotherapy and Personality Change. Chicago: University of Chicago Press, 326.
 Jessie Taft. (1933, 1962). The Dynamics of Therapy in a Controlled Relationship. NY: Dover, 120.
 Carl Rogers. (1959). A theory of therapy, personality, and interpersonal relationships as developed in the client-centered framework. Psychology: A Study of a Science, 3. NY: McGraw-Hill, 184-256, 210.
 C. Rogers. (1951). Client-Centered Therapy: Its Current Practice, Implications and Theory. Houghton Mifflin, x-xi
 C. Rogers. (1975). Empathic: An unappreciated way of being. The Counseling Psychologist, 5 (2), 2-10, 4.
 Ajahn Sucitto (n.d.). Cultivating Empathy. Retrieved from https://ajahnsucitto.org/articles/cultivating-empathy/
 Jean Decety & Philip L. Jackson. (2004). The functional architecture of human empathy. Behavioral and Cognitive Neuroscience Reviews, 3(2), 71-100, 93.