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Empathy: Innate and You Must Be Trained

Empathy training can pay dividends for your company.

One of the authors of this piece went for a medical exam: The primary care physician sat behind her computer with the screen covering half her face. She glanced at her patient and said with no affect, “You are in danger of getting Type 2 Diabetes. You need to lose 25 pounds.”

The author remembers wondering why his insurance company was paying for this physician’s services: That same message could have been conveyed by email or on his Apple Watch. The doctor’s warning made a profound impact...for 24 hours. It was then forgotten.

In The Empathy Effect , Helen Riess, M.D. mentions a survey asking physicians if they had initiated discussions about cancer risks with patients. More than 70% responded that they had. And yet 30% of patients remember their doctors broaching such a conversation.

Twenty percent of these patients were eventually diagnosed with cancer. When doctors communicate well with patients, lives can be saved. When doctors rely on the power of words and data alone, lives can be lost.

The best leaders understand that gap between what leaders say and what target audiences hear. They know how to fill in that gap.

Empathy is a Leadership Issue

One of the authors received the following note from a CEO discussing a direct report:

  • X’s affect is read negatively by colleagues and he struggles relating to people.
  • X doesn’t demonstrate engagement / empathy appropriate to the subject matter.
  • X is having difficulty building a productive working relationship with a junior direct report who needs management, coaching, and support.

This CEO believes empathy is a leadership issue. Is he correct? In a 2015 survey of 160 companies, the top ten businesses with high levels of leadership empathy generated 50 percent more net income per employee than the bottom ten.

A study conducted at Massachusetts General Hospital showed that patients rated more emphatic physicians as also being more professionally competent. People factor empathy as one of the critical elements of physician competence. (Riess, 2018).

It is a mistake to assume that being perceived as a competent leader requires stereotypical male behaviors of focusing on facts while ignoring emotion. Writing in Fast Company magazine, the CEO of Big Four CPA Firm Deloitte titled his piece: “Nice-Guy Leaders Actually Finish First.” And one reason they do so well is that they are able to express empathy with clients and team members. (Saltzberg, 2014).

Empathy, Not Sympath y

Dr. Riess is Associate Clinical Professor of Psychiatry at Harvard Medical School and Director of the Empathy and Relational Science Program at Massachusetts General Hospital. She co-founded and serves as CEO/Chief Scientific Officer of a SaaS (software as a service company) she founded called Empathetics, Inc. It provides a cloud-based platform to train medical professionals and leaders in emphatic communication.

The term “empathy” did not come into existence until the early twentieth century. It is derived from a German word meaning “feeling into": Suppose you look out your office window and see someone in a heavy downpour shivering with cold. Sympathy is being cognitively aware that this person is uncomfortable without an emotional component. Empathy, on the other hand, is feeling as if you are standing next to the person in the rain. You are experiencing their discomfort as if it was yours. There is an emotional connection. At the same time, you are aware that you are comfortably dry in your office. Empathy is defined as “the ability to appreciate the other person’s feelings without being so emotionally involved that your judgment is affected.”

Empathy is Genetic

Our bodies may be programmed to be emphatic with those who are genetically like us: Observe mothers and their infants. It is easy to be emphatic towards people in our community who share similar values. We naturally feel empathy towards those who are like us. And this makes survival sense: By emphasizing with someone else’s pain, you learn to avoid the source of pain while simultaneously being motivated to help that injured person.

Empathy Must Be Learned

Our genetic programming toward empathy has limits. The emphatic response may not automatically generate when dealing with someone "different." As the demographics of the United States becomes increasingly diverse and women take on more important roles, working with people unlike us will become more common.

We may not hard-wired to be empathic towards team members or customers who are not like us. But empathy can be learned. Using a framework called “E.M.P.A.T.H.Y” ® described in her well-researched book, Dr. Riess has been teaching physicians how to properly “read” their patients' emotional states and how to employ behavioral techniques to demonstrate emphatic behavior. And after the empathy-enhancing intervention, she found that the trained group of physicians received significantly higher patient satisfaction scores than a control group of physicians.

M is for Muscles of Facial Expression

We recommend you read Dr. Riess’ book or go to to get a full sense of the “E.M.P.A.T.H.Y” ® framework. In this post, we will focus on “M.”

Watch a mother with an infant toddler. When the child is smiling with delight, the mother’s face will automatically mirror the child's face: the mouth will turn up into a smile and her eyebrows will rise. This instinctive reaction by the mother sends the child this message: Your joy is my joy.

When the child is crying, the mother’s mouth and eyebrows will turn down. The mother is sending this message to her child: Your pain is my pain. One researcher describes this as “psychological oxygen” for the child.

Now let us assume the following business scenario: A subordinate comes by your open door and says with a grin, “I just closed that important sale today!” You head moves up and down in affirmation of the message. You might even comment, “Nice job.” Your face, however, does not mirror your subordinate’s grin. Indeed, you are looking grim because you were immersed in writing an email when that subordinate interrupted you.

What happened? Your words convey affirmation. Your nonverbal message is: “You bother me.” Which message do you think carries more weight for that employee?

Empathy Skills Are Worth Cultivating.

Dr. Riess suggests that if you wish to be an effective leader in an increasingly diverse work world, empathy can be learned. Do not assume you naturally have empathy. You probably do not.

As more work is conduct online, how do leaders appropriately convey empathy in virtual settings? One of our client leaders has a well-deserved reputation for empathy in one-on-one real-time settings. But much of her work is conducted online. We received complaints of negativity and disinterest among those had to deal with her using video links.

It turns out that staring at a tiny camera lens on her laptop for sixty minutes is boring! As she got bored, she would move her eyes downward to examine notes or to check emails on her mobile device. Participants observed the lack of eye contact and the furrowing of her brows. They interpreted the look as displeasure. Whether displeasure or distraction, the message was the same: lack of empathy. At our recommendation, this leader’s daughter drew a child’s picture of a funny eye on a yellow “Post It” note. It was placed next to the camera lens. The distracting mobile device was removed from sight.

In short, leaders should not assume they have “natural” empathy. In professional settings, they probably do not. Want to be a more effective leader? Start with learning empathy skills.

There is a secondary benefit: Expressing empathy towards others is the best way to get empathy from others.


Riess, H. THE EMPATHY EFFECT: seven neuroscience-based keys for transforming the way we live, love, work, and connect across differences. (2018) Boulder, CO: Sounds True.

Saltzberg, B. FAST COMPANY. “Five Reasons Why Nice-Guy Leaders Actually Finish First,” 2014.