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True Empathy: A Physical Sensation

Understanding the neurobiology of empathy

He was robust little boy who gave a big smile as he intently followed his mother's face. Emily felt he was doing well. So well, in fact, that she was attributing qualities to him for which he seemed to young. "It's good for him to comfort himself, right? I should let him cry, right?" She seemed very anxious.

About a year earlier, Emily had lost a baby, Christopher she called him, in her ninth month of pregnancy, when she was in a car accident. She conceived again almost immediately. And here was this miracle baby. I watched Michael sleeping in his blue jumper. He seemed so small and vulnerable.

"He's doing great," I said. Emily continued to wear that uncertain look as I tried to reassure her. She asked about sleep. "Is it OK if he is still in our bed? Is it good for bonding?" she asked. I was puzzled by this question and paused, asking her to tell me what she meant.

"Is he bonded to me?" she asked. I started to attempt an answer when she interrupted me. "Can you bond in utero? I mean I bonded to Christopher, but he died. I didn't let myself bond to Michael when I was carrying him."

I thought of this moment when listening to Francine Lapides, in her terrific course Keeping the Brain in Mind ( which I refer to in a previous post How to Grow a Child's Brain) explain the neurophysiology of empathy. It was an "aha" moment for me. Empathy is a commonly used word in mental health, and I admit to having used it for years without really appreciating its meaning.

Empathy, she explained, is largely mediated by a structure called the insula. It is predominantly a right brain structure that connects to the visceral organs-the heart and intestine. It also connects the brain with the skin and mediates sensations of touch and temperature. It is responsible for what is commonly referred to as a "gut feeling." Empathy, then, in its truest form, means to literally feel what another person is feeling.

Psychiatrist Daniel Siegel, in his paper Mindful Awareness, Mindsight, and Neural Integration defines empathy as "the capacity to put yourself in the mental perspective of another person." It is not an intellectual understanding, as in "I understand how you feel," which is primarily a left brain activity.

True empathy, an actual physical experience, is somewhat rare. Empathy has healing power, both for the listener and the person being heard. It represents a profound attunement between two human beings. It is something to strive for in all relationships.

With Emily I wondered aloud if getting pregnant so quickly had prevented her from doing the difficult work of grieving the loss of her first child. She said to me, "I feel like I can't give all of myself to Michael. I have to hold back to protect myself."

At that visit with me, perhaps fortified by our moment of connection, of true empathy, she found the courage to face this task of grieving. She recognized it was critically important not only for herself, but for her relationship with her infant son.