A common question for medical interviews.
'I feel sorry for you.'
Ouch. That's not a sentence we want to hear. It comes from someone feeling superior. We realise the speaker isn’t sharing our problem and they have their own feelings about it.
'I really understand what you're going through.'
That one feels nicer. It shows the power of empathy. We can put ourselves in someone else's shoes and let them know we relate to their experience of the world. The writer Philip K. Dick went as far as to say empathy is what makes us human.
Over Christmas weekend in 2020, Chris Whitty, England's Chief Medical Officer, was not at home with his family, but on a north London hospital’s respiratory ward. Whitty chose to be on the front line of the pandemic and lead by example.
If he had wanted to show sympathy for front-line nurses and doctors, he would have written 'I feel terrible that this is so hard for you...', in a tweet from his living room. What Whitty actually demonstrated was a level of empathy we all hope to see in healthcare. He put himself in the shoes of those in a worse position - voluntarily.
Dr. Brené Brown, an American professor and popular thought leader, says:
Empathy fuels connection. Sympathy drives disconnection.
Dr. Whitty was showing connection in his solidarity with the frontline healthcare staff. He was not trying to solve their problems or tell them they were unfortunate, as that is not part of empathy.
People fundamentally don’t want pity. We want someone to listen and understand what we are feeling. When others share similar experiences, it helps us understand our own issues. Healthcare is a great example of this, because it is a pressured environment, and highly emotional for both staff and patients.
Sympathy is not a bad emotion, and is a natural part of human experience. The positive side of sympathy is that it leads to compassion, and this is a trigger for action. The tricky side is that it’s not useful to show people your sympathy, as it undermines them.
Action is what can relieve someone's suffering. When we take action, it doesn't really matter what our motivation is. If you see a homeless person, you may feel sorry for them and be driven by compassion to give them some food or money. That is not a bad action or motivation. But if you were unaware of the effects of sympathy, you might say something like 'oh, you are probably cold and hungry and I feel very sorry for you'. This wouldn’t help the person’s self-esteem and showing your true motivation in this way is not emotionally beneficial.
Empathy has been a requirement in medical education since the 1980s, and the GMC has gathered enough data to justify putting this skill at the core of the curriculum.
Recent clinical studies have shown that metrics ranging from lung function and time in hospital to patient experience and perceived pain all improve when a doctor shows empathy. It can even shorten the length of a virus, such as the common cold.
Empathy lowers patients’ anxiety and distress and delivers significantly better clinical outcomes.
A highly-regulated place like a hospital can quickly turn into an inhuman environment without key people skills like empathy. The word ‘clinical’ is actually used as a synonym for an environment that lacks humanity.
Imagine a sick patient being told, “I feel sorry for you”. It would feel deeply isolating. Just that linguistic nuance can change a heartfelt sentence into a patronising insult. It’s isolating, because it means the doctor is identifying as separate from the patient, patronising because saying a bad situation is bad suggests the patient didn’t realise that already.
Empathy is a skill, not an innate ability. Like most skills it is broken into sub-skills:
What are their main stressors? What does their body language suggest?
How might they be feeling? Asking yourself this question can become a habit. It is important to reflect on what the person may have experienced in the days and hours leading up to your meeting. You can use your past experiences as a shortcut, or simply rely on your intuition.
You already know about avoiding too many personal pronouns, but there are wider considerations, such as your tone of voice, your body language, and the words you choose. Psychologists are famously cautious with their language for this very reason.
As you can see, none of these sub-skills require you to feel someone else’s emotions or to be a very emotional person. Providing you can recognise how someone is feeling, you can take the necessary steps. Our autopilot is to see the world from our own perspective, but regular practice can help you step outside of this more easily. Mental exercises of this type improve the way you relate to other people in your life.
Practice with these example empathy questions to put these lessons into action.