Melayna Schiff – Empathy: An Activity, not an Attribute

Empathy: An Activity, not an Attribute
Melayna Schiff

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Introduction

In Kohut’s writings, Stolorow (1993) tells us, there emerge two uses of the concept of empathy. There is, on the one hand and more or less consistent with Kohut’s (1959) original conception of it, the notion of empathy as an investigatory stance, as “a mode of observation attuned to the inner life of man” (Kohut 1982: 396). On the other hand, there is the notion of empathy as a mode of affective responsiveness and bonding, as, that is, a “powerful emotional bond between people” (397). What we need to do, Stolorow argues, is keep to Kohut’s (1959) original conception of empathy as a special investigatory stance and use a different term, ‘affective responsiveness’, to designate the phenomenon of the powerful emotional bonding between people. For, Stolorow argues, these two uses of the concept of empathy actually get at distinct ways of being with an other.

Now, Kohut himself talks about empathy in at least three ways (see Kohut 1982). On the one hand, he discusses empathy from an experience-distant, or meta-theoretical, perspective. From this experience-distant perspective, empathy is considered in an epistemological context as a way of knowing. On the other hand, Kohut discusses empathy from an experience-near perspective. From the perspective of experience-near theorizing, Kohut distinguishes two levels of empathy: (1) as an information gathering activity of the analyst and (2) as a powerful emotional bonding between people (1982: 397). Thus, despite the fact that he did feel ambivalent about continuing to distinguish these notions of empathy as different levels of the same phenomenon, Kohut unswervingly continued to do so.[1]

In line with Kohut’s insistence that the two notions of empathy which Stolorow wants to distinguish are actually different aspects of the same phenomenon, I want read the notion of empathy as an information gathering activity together with the notion of empathy as affective responsiveness in order to get at the overarching phenomenon to which they both point and in which they are both, as I will argue, equiprimordially co-implicated. With this phenomenon in view, I will attempt to articulate a robust conception of empathy as something more than, but still indebted to, what either of these two aspects of empathic activity could make of a concept of empathy on their own. In short, the robust conception of empathy which I posit advances empathy as an essentially intersubjective and mutually regulated receptive-response exchange in which patient and analyst lead and accompany each other through a temporal process of psychical experiencing which neither of them has created but in which they both, essentially, participate.

We will start by considering the final conception of psychoanalytic cure articulated by Kohut (1984). By first looking at the subtle work that empathy is playing in this Kohutian framework of effective psychoanalytic treatment, we will get a sense of what empathy, as a phenomenon, looks like in the context of meaningful situation.  We will then consider the conception of empathy that Kohut articulates from the perspective of experience-distant theorizing. This will provide us with a background for our discussion of the two levels of empathy gotten from experience-near theorizing. In our considerations of the two levels, I will attempt to show that these notions of empathy function in the Kohutian framework of effective psychoanalytic treatment as the pragmatic consequences of Kohut’s conception of empathy gotten through experience-distant theorizing. The aspect of empathic activity spoken about as an ‘investigatory stance’, I argue, gets at the analyst’s pragmatic participation in empathy in the analytic space, while the aspect of empathic activity spoken about as ‘affective responsiveness’ gets at, primarily, the patient’s pragmatic participation in empathy. Thus, while Stolorow insists that these two notions of empathy get at distinct ways of being with an other, they emerge, on my account, as different aspects of a particular way of being with each other.

1

In his final work, How Does Analysis Cure? (1984), Kohut argued that psychoanalytic cure is gotten through the successful negotiation of the presence and absence of empathy at particular crucial moments in the psychoanalytic situation.  An empathic bonding and breakdown sequence between patient and analyst is specifically advanced as bringing about such an effective treatment. What is at stake in our grasp of Kohut’s conception of empathy, then, is not least our understanding of the pragmatic material contexts in which, according to Kohut, occurs psychoanalytic cure.

In this work, Kohut (1984) posits empathy as the basis of the essential activity involved in the basic therapeutic act. The fundamental constituents of the basic therapeutic act, Kohut maintains, are that of understanding and explaining (94).  “In the understanding phase, the analyst verbalizes to the patient that he has grasped what the patient feels; he describes the patient’s inner state to the patient, thus demonstrating to [her] that [she] has been “understood,” that is, that another person has been able to experience, at least in approximation, what [she herself] experienced, whether, for example, the experience in question is one of inner emptiness and depression or of pride and enhanced self-esteem” (176-177). Here, the basic step is the appreciation by the analyst of what the patient is experiencing (feeling, sensing, etc.). This appreciation by the analyst of what the patient is experiencing can, moreover, be communicated to the patient through explicit, verbal utterances or through implicit, nonverbal means; in short, it is communicated through the analyst’s embodied engagement with the patient.

The explanatory aspect of the basic therapeutic act is also based on empathy. Here, however, the accuracy, breadth, and depth of the analyst’s genetic interpretations will be strongly influenced by his theoretical equipment (Kohut 1984: 184).  Moreover, there is in the explanatory phase an important difference from the understanding phase. This difference is not only a cognitive one but, more significantly, an emotional one:

The intensity of the archaic bond of an identity of inner experiences based on the analyst’s ability to perceive the patient accurately and then to communicate what he perceives is lessened as the analyst moves from understanding to explaining. Yet, and this is the crucial point, while the archaic merger is lessened, an empathic bond on a more mature level of experience supplants what has been left behind. The empathic connectedness between patient and analyst is thus retained and, beyond doubt, even deepened in its scope via the analyst’s imparting his dynamic and genetic insights to the patient. As he engages in his explaining activity, the analyst enables the patient to continue to feel supported by the fact that he, the analyst, retains his selfobject[2] functions and, ipso facto, enables the patient to become more objective vis-à-vis himself and his problems (Kohut 1984: 185).

Through the understanding-explaining sequence, which arises and is maintained in and through the empathic activity between the two, a working-through process is set up that re-creates in analysis a situation in which the patient may develop a more cohesive and resilient self that is able to seek out for itself the fulfilling responsiveness of needed human others, a self which can, at the same time, be sustained by and through her empathic resonance with others, in contrast to a defective self that needs archaic ties for her survival. Now, precisely what is this empathic activity which underlies the understanding-explaining sequence is what we are after.

In the context of and through the patient’s experience of and participation in the analyst’s understanding, a need that had been thwarted in the patient’s development is reawakened, this time, however, directed at the analyst. This need manifests itself as a dependence on the analyst to serve for the patient specific psychological functions that she cannot perform for herself. Such psychological functions, generally speaking, include the mirroring, idealizing, and alter-ego selfobject transferences. Inevitably, however, there occur breakdowns in the patient-analyst system. For, the analyst cannot always know and be precisely what the patient needs him to be. These breakdowns are empathic breakdowns where the patient’s dependence on the analyst is frustrated. According to Kohut, these instances when the empathic activity between patient and analyst breaks down are key pieces of the working through process which leads to psychoanalytic cure. The patient, in these instances, turns away from the analyst, emotionally retreats. In the case of optimal frustrations[3], where, for long enough, there is a non-fulfillment by the analyst of the direct need of the patient, the working through of this frustration and the re-establishment of a bond of empathy between the patient and analyst leads to what Kohut calls ‘transmuting internalization’, whereby the patient incorporates into her self the psychic structure that is needed to meet or at least deal with the lack of fulfillment of the need for whose gratification she depended on the analyst.[4]

While the basic move towards an effective psychoanalytic treatment is the appreciation by the analyst of what the patient is feeling (Kohut 1984: 96), the final move of analysis is the shift from the patient’s dependence on the analyst as archaic selfobject with whom she can merge to the establishment of a bond between patient and analyst in which the analyst is recognized and functions, generally and for the most part, not as a part of the patient’s self that is necessary for her cohesion, but  in a developmentally mature way, as a source of calmness, strength, and understanding (Kohut 1984: 77). This shift occurs, in short, in and through the establishment and maintenance of an empathic-boding and -breakdown sequence between patient and analyst.

Now, the establishment and maintenance of this empathic-boding and -breakdown sequence, and, as such, the movement towards psychoanalytic cure, I argue, does not simply occur in virtue of some particular quality or activity of the analyst, not simply in virtue of him performing the basic therapeutic act or attending to the patient in and through a particular investigatory stance. As has been said, according to Kohut the condition for the possibility of all of this is empathy, and insofar as empathy is, as I will argue, the condition for the possibility of the analyst being receptive and responsive to the patient in such a way that the patient may feel understood by him, empathy is not an attribute that can be predicated of the analyst but is, rather, an intersubjective activity. It is this notion of empathy as an essentially intersubjective activity towards which we are working in the next section through our method of reading together the notion of empathy as a mode of observation and the notion of empathy as affective responsiveness.

2

In his seminal paper published in 1959, Kohut posited introspection and empathy as delimiting the psychical field (Kohut 2010). Because the psychic realm is coextensive with whatever can be disclosed through introspection and empathy, and because it is in virtue of introspection and empathy that we are able to observe mental life at all, introspection and empathy, Kohut argues, must serve as the essential constituents of the psychoanalytic mode of observation, of, that is, psychoanalytic fact finding. That introspection and empathy are the essential constituents of the psychoanalytic mode of observation is the case both in the sense that, even though other acts may be employed in conjunction with them, introspection or empathy are necessarily involved in all observations of mentality, and they may be present alone (Kohut, 1959: 462). To say, on the one hand, that introspection and empathy may be employed in conjunction with other acts in order to observe psychic life and experience is to account for cases in which one engages in, say, an imaginative, deliberate process in and through which one grasps something essentially psychological, such as in the case of the unusually tall man (461). To say, on the other hand, that introspection and empathy may be present alone is to account for cases, such as those which crystalize in the psychoanalytic situation between the expert analyst and his patient, where introspective and empathic acts may occur without deliberate effort and where there is not, in fact, another act employed in the observation of the psychic. According to Kohut, in short, introspection and empathy are necessarily employed in the grasping of mentality, with and through other acts or all on their own.

Considered in an epistemological context as a way of knowing, empathy, Kohut (1984) writes, “is a value-neutral tool of observation which (a) can lead to correct or incorrect results, (b) can be used in the service of either compassionate, inimical, or dispassionate-neutral purposes, and (c) can be employed either rapidly and outside of awareness or slowly and deliberately, with focused conscious attention. [It is defined] as “vicarious introspection” or, more simply, as one person’s (attempt to) experience the inner life of another while simultaneously retaining the stance of an objective observer” (174-175). Kohut’s definition of empathy as vicarious introspection is directly related to his idea that, through empathy, one can from an objective standpoint observe the psychic experience of an other. By emphasizing that empathy is objective, Kohut struggles to make us aware of the fact that the psychic life of the other is observed not through a mysterious telepathy of sorts but, rather, through one’s own personal affective experience (Lessem 2005). And by defining empathy as a kind of introspection, Kohut tries to call our attention to how the emergence of an interpretation from empathic receptivity is mediated and made possible by one’s awareness of her own receptivity to the meaningful expressions of the other’s sensory-affective life (Agosta 2010).

In the psychoanalytic setting, Kohut tells us, the analyst is supposed to maintain a position of prolonged empathic immersion in his patient’s subjectivity. What this means is that, rather than understanding and interpreting his patient on the basis of his theories, the analyst is supposed to try to understand and interpret his patient from his patient’s experience (Lessem 2005).[5] This requires the analyst to make a focused attempt to enter the “subjective reality” of his patient (Orange 1993), to experience, that is to say, what things are like for his patient and the meanings that they have. The analyst, Kohut maintains, should introspect the vicarious experience aroused in him by the other, and through this introspection, Kohut supposes, the analyst can from an objective standpoint observe a psychological fact.

We will now turn to consider how empathy, as described above, plays out pragmatically between patient and analyst in the Kohutian framework of effective psychoanalytic treatment. Considered pragmatically from the standpoint of the analyst, I argue, empathy is a data-gathering activity through which the analyst is affected – led, as it were, by and into – a psychical experience that is not of his own making. This data-gathering activity, as a being-lead-into, informs the analyst’s interpretive response activity, which, according to Kohut, is the understanding-explaining sequence.

Since, I argue, all interpretations gotten through the analyst’s empathic receptivity emerge through and are made possible by his awareness of his own receptivity to the meaningful expressions of the other’s sensory-affective life, the analyst’s interpretations of what the patient is experiencing are shaped by his own subjectivity. For, if the analyst’s attentional awareness tends to be directed towards some objects and not others as a result of the analyst’s own unique constitution, and if the analyst tends to attribute certain meanings rather than others to things also as a result of his particular make up, then the analyst’s interpretations of the patient, mediated and made possible in the way described above, are gotten through and shaped by his own subjectivity.

Empathy, considered pragmatically in this way as a data-gathering activity of the analyst, is not, moreover, that which satisfies the selfobject need of the patient. Rather, empathy is that which guides the correct and accurate actions and responses of the analyst. Empathy, in this sense, informs the appropriate therapeutic selfobject function vis-à-vis the patient, but it is not, by itself, the selfobject function which the patient needs (see Kohut 1982: 397). Kohut, in suggesting that the analyst should maintain a stance of prolonged empathic immersion, in other words, does not, contra Stolorow’s (1993: 44) interpretation, suggest that the analyst’s empathy amounts to him providing for the patient continual selfobject experiences free from painful repetitions of past childhood traumata. Rather, he simply suggests that analyst should try to understand the data he receives from the standpoint of his patient’s experience, not from the standpoint of his theories. And understanding the data he receives from the standpoint of his patient’s experience, I argue, involves the analyst being-led-into a psychical experience, through his empathic receptivity, by his patient, and this leading of the analyst into the psychical experience is what sets the conditions for the fulfillment or frustration of the experience which the analyst takes the patient as having.[6]

Considered pragmatically from the standpoint of the patient, empathy is the patient’s experience of the analyst’s felt understanding. For, empathy, considered from the standpoint of the patient, is not, strictly speaking, for Kohut a quality or act of the analyst, but it is, rather, the patient’s experience of the analyst’s response (Lee, Rountree, & McMahon 2009). To be sure, in the psychoanalytic situation, a condition for the possibility of empathy actually having occurred at all is, for Kohut, the patient’s experience of the analyst’s response as an in-tune response or, in other words, the patient’s experience of the analyst as psychologically attuned to her. This is the aspect of empathy which, Kohut claims, “the mere presence of…has…in a broad sense, a therapeutic effect – both in the clinical setting and in human life in general” (Kohut 1982: 397).[7]

The responsive in-tuneness of an empathic human surround – the experience, that is, that other psychical beings are aware of you as having your own sensory-affective experiences which they can more or less experience too – is, according to Kohut, a psychological necessity. It is, generally and in most cases, the absence of a responsive in-tune human surround that has led to the defect in the patient’s self, according to Kohut, and it is in virtue of and through the empathic environment constituted by the patient-analyst system that that very defect can be cured.

The patient’s experience of the analyst’s felt understanding is not a separable moment of passive recognition by the patient of something that already finished happening. Rather, it is part of the dynamic context in and through which the analyst’s interpretive activity unfolds. In other words, the understanding and enacted appreciation by the analyst of what the patient is experiencing unfolds in real time together with and through the patient’s experience of it. Thus, patient and analyst are co-implicated in this empathic activity, and empathy, we find, is not a quality or attribute of the analyst but is, rather, an intersubjective activity. This empathically enabled receptive-response exchange between patient and the analyst, I argue, amounts to a mutually regulated leading and accompaniment.

At this point we have gotten a sense of the underlying empathic activity we sought earlier when we considered Kohut’s framework of effective psychoanalytic treatment: If we consider simultaneously both the activity through which the analyst gathers data about his patient’s experience and that activity through which the patient experiences the analyst’s response as psychologically attuned to her, we find they both point toward a phenomenon of which they both are aspects, indeed a phenomenon in which they are both essentially co-implicated, namely the phenomenon of empathy as a mutually-regulated, intersubjective, temporal activity.

The patient, through her free associations, leads the analyst into and through her subjective reality in order for him to grasp, understand, and, ultimately, explain it. While the analyst, for his part, leads the patient through the transference analysis and interpretation. In and through their embodied engagement with each other, patient and analyst move each other with their affect-laden words and comportments. The patient feels the analyst grasp and share with her the psychical experiences which he can more or less feel too, as he moves with her knowingly through those experiences, comprehends what they are like for her and the meanings that they have, and, through his comprehension and clarification, transforms their significance.

In the explaining aspect of the analyst’s interpretation, the analyst departs from moving just with and in the space they share and negotiate through their mutually regulated understanding, and he intervenes with his theoretically guided and felt elucidations. Through the articulation of dynamic and genetic insights, the analyst generalizes the experience of the patient by situating it in larger contexts of significance, while still remaining there for her in the psychologically needed way.[8] By disrupting the intensity of the archaic bond established through the willingness of the analyst to follow the patient along into and through her subjective reality and share experiences with her, the analyst’s explaining activity lessens the intensity of the patient’s archaic tie to the analyst.  Given that, through his explaining activity the analyst is still being with the patient in an experience-near way and operating in and through his experience of her feeling psychologically attuned to him, this  provides the opportunity for patient and analyst to engage in an empathic bond on a more mature level where the patient does not for her immediate psychological cohesion depend on the functioning of the analyst-other but, rather, is simply sustained and strengthened by their shared psychical experiencing.

While the explaining activity of the analyst is, like his understanding activity, guided by the analyst’s experience of the patient as feeling understood by him in the way described above, things are most likely to break down during this explanation aspect of the analyst’s interpretation (Kohut 1984: 101-103). The analyst’s dynamic and genetic explanations, that is to say, are, from the standpoint of the felt experience of the patient, more likely to miss the mark than the analyst’s understanding activity on its own. The analyst’s “missing the mark” occurs in real time with and through the shift from the patient’s experience of the analyst as psychologically attuned to her to the analyst as being out-of-tune and radically other. In and through this empathic breakdown, the patient withdraws into her self and disavows her felt need for the empathic resonance of the analyst.  Given our conception of empathy, we can see the sense in which this breakdown is not a failure of the analyst’s empathy, as if empathy were a predicate that could be attributed to him, but rather, it is a failure of the patient-analyst system.

The working through of the frustration is a dialogical process through which the patient and analyst inform and re-inform each other’s perspective in order re-establish a bond of empathic resonance. If this frustration is an optimal one, through the working through of the frustration and eventual reestablishment of a bond of empathy between patient and analyst the patient incorporates into her self the psychic structure for which she depended on the analyst prior to the breakdown in order to meet her psychological need which she could not previously meet for herself.

3

Recent self psychologists (e.g. Orange 1993) have argued that, in Kohut’s account of psychoanalytic cure, the notion of countertransference has been neglected. The ideal for the self psychologically oriented analyst was, according to Kohut, to empathize with the patient’s experience. This ideal had a significant negative consequence for self psychological theory (Lessem 2005). For, because of the emphasis on the empathic therapist, the way in which a particular analyst contributes to the shaping of his patient’s experience had not been addressed. The robust conception of empathy that I have proposed is supposed to present a way of thinking empathy that accords well with Kohut’s conception of effective psychoanalytic treatment while, at the same time, providing a way to, in our conception of the empathic process itself, account for how a particular analyst contributes to the shaping of his patient’s experience.

Recall that the analyst’s interpretive interventions emerge, on my account, through his own subjectivity and affective experience. The fact that the analyst’s grasp of the patient’s experiences are gotten through his own subjectivity and affective experience entails the result that, although the patient leads the analyst into her psychical experience, subjective qualities of the analyst contribute to precisely where this leading brings him and what meaning he attributes to it. This also holds true for where and how the analyst leads a patient into psychical experiences. The analyst is led into a psychical experience by his patient which has been shaped by aspects of his unique constitution and affective reality, and thus, the interpretations that he makes from his empathic receptivity about those experiences are always marked in some way or another by him, particularly by his affectivity and theoretical repertoire. The way in which the patient organizes her experience and makes sense of things will, as a result, be influenced by the analyst’s responses in general and interpretations in particular. This shaping by one of an other’s experience is not, in some sense, something that ought to be feared or avoided. Rather, this shaping is, I argue, constitutive of how we are able to experience what things are like for each other at all.[9]

 

Conclusion

In this paper, I have posited empathy as an essentially intersubjective and mutually-regulated temporal activity between patient and analyst which, in short, amounts to a leading and accompaniment. Specifically, I have attempted to show that, considered in the framework of Kohut’s conception of effective psychoanalytic treatment, the two levels of empathy which Kohut distinguishes point to an overarching phenomenon, from which I have articulated the  conception of empathy described above. As such, what Kohut refers to as ‘levels’ of empathy, I argue, should be spoken of as being different aspects of empathic activity. As equiprimordial aspects of empathic activity, both ‘levels’ co-implicate each other and depend on each other for the condition of their possibility. The aspect of empathic activity which Kohut talks about as a data-gathering activity of the analyst addresses, in Kohut’s framework of effective psychoanalytic treatment, the pragmatic activity of the analyst in the psychoanalytic space, while the aspect of empathic activity which Kohut talks about as affective responsiveness addresses, primarily, the pragmatic activity of the patient in the psychoanalytic space.[10] That which leads the analyst to respond appropriately to the patient depends on the analyst grasping, more or less correctly, the experience of the patient, on, that is to say, the patient feeling understood by him.[11] And the patient’s experience of the analyst’s response as being psychologically attuned to her depends on the analyst being led to correctly and accurately respond to her, on, that is to say, the patient engaging with the analyst, and re-engaging when the empathic bond between them breaks down, in a receptive-response exchange in which the two negotiate and mutually-regulate meaning and experience. Empathy, as such, is achieved not through a static act but, rather, through a fundamentally dynamic, dialogical process which unfolds, intersubjectively, through time.[12] And, insofar as empathy is understood in this way, we find that ‘empathy’ does not refer to a particular quality or activity of the analyst but, rather, to a relational activity between patient and analyst. Furthermore, this conception of empathy is theoretically helpful when attempting to reconcile Kohut’s conception of empathy with issues of countertransference.

 

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