empathy vs sympathy

snowfreeze, BSN, RN · Oct 25, 2006

Empathy involves putting yourself in the patients place. To truly understand how a patient is feeling about their problem or coping with the same, you need to listen. Listen very carefully and not put what they tell you into your own words or perspective. Your solutions to the patients problems are not what the patient is looking at as acceptable solutions.

TazziRN, RN · Oct 25, 2006

Sometimes empathy is truly knowing what the pt is going through, or at least trying to understand. Being empathetic can often mean not saying anything.

moongirl · Oct 25, 2006

empathy is trying to understand the pts pov- pain, suffering, emotions whatever. It is realizing how you would feel if you were in their shoes. Sympathy is feeling sorry for them

Tweety, BSN, RN · Oct 25, 2006

Some of the empathetic responses are "you sound angry.........". "I know if this were happening to me/or my child I'd feel.........how do you feel.".

Stuff like that.

DusktilDawn · Oct 25, 2006

Empathy is the ability to put yourself in another persons position and see that position from their point of view. It's not necessarily agreeing with that point of view, it's more about understanding their reason and rationale for that viewpoint and acknowledging that they have the right to their point of view. It's being able to try to understand how another person may feel. It's about acknowledging that a person has the right to feel the way they do, although we may not fully understand why they have those feelings.

For instance:

I once had a patient my age who was diagnosed with terminal cancer. At times, he would react with anger towards people, including his father who was at his side constantly despite being a target at times for his son's anger. In fact this father never seemed to take his son's outbursts personally, nor did he react to them. He willingly, lovingly, and tenderly provided care for his son. I overheard staff talking about how this patient treated his father and how they thought it was wrong, disrespectful, how he was jerk, blah, blah, blah. As I was listening to what other staff were saying about this situation, I though about how I would feel if I was in this patient's position and than I responded towards the other staff with these thoughts: I told them that if I was in this persons shoes, I'd probably be angry too. This patient is young (29), has a wife and 2 small children (2-3 yrs approximately), and has just been told he's dying. He's never going to be there for all the "firsts" with his kids (ie: first day of school, first day little league, first bike, first school play, etc) nor will he be there to watch them grow and support them through their childhood into their adulthood. He'll never see them marry or have their own children, he's never going to be a grandfather. He's not going to be there for his wife, the person he chose to share his life with through the good, the bad, grow old with, etc, she will have to face the future alone because he will not be there to support her. At 29, this man is being told he has no future. It makes sense that he's angry, he no doubt feels life has dealt him an unfair hand. If this father could, he would take his son's place in a minute, however it is not something he can do. He takes his son's anger, and takes it willingly because right now it is the only thing HE CAN DO for his son.

Other staff had only been looking at the behavior of this patient instead of considering why he was behaving this way. Can I understand why this patient was angry, yes I can. Does it mean I understand what it is like to be diagnosed with a terminal illness, no it does not. There are things about that situation like that I cannot possibly understand. It's also important to acknowledge when you don't understand what another is going through, it allows them the opportunity to tell you. It's about being willing to understand the other person.

For instance:

I've had a patient where ambulation was important. I understood why the patient didn't want to move, she was in chronic pain along with post-op pain. Personally I've never experienced both chronic pain and post-op pain. The patient blurted out to me: "YOU don't understand what I'm going through! You don't know how I feel! YOU DON'T CARE!" My response was: "Your right, I don't understand what your going through, I can only imagine what you are going through which is certainly not the same thing as fully understanding what you are going through. I also don't understand how you feel, I'm also not telling you how should feel about this, I can only understand what you tell me. However, you are wrong about me not caring. If I didn't care, I would let you lay in that bed and leave you to your own devices. I do care, which is why I'm pushing you to do what I know needs to be done to facilitate your recovery." This exchange totally changed the nurse-patient relationship towards the better. I had a patient that felt free to express how felt with me and we could now work together to facilitate her recovery.

Sympathy is more about commiseration. It's more about sharing mutual feelings. As another poster stated, it's about feeling sorry for another person. In effect, how does feeling sorry for another benefit them? Sometimes it prevents people from doing what needs to be done because they're more concerned with making the person feel worse. Sometimes sympathy causes others to do things for another that may not be to that person's benefit, which can impede their progression forward from a situation. It may cause one to "pamper" or "cater" to another in an effort to make them feel better which may do more harm than good.

Sympathy is usually not very productive, while being empathetic can be.

For instance:

Sympathy may cause me not change my patient's wound packing because it's such a painful ordeal for that patient.

Empathy will cause me to offer this patient an analgesic prior to doing that wound drsg.

As a nurse, I guess I view empathy as being able to understand, or at least trying to understand my patient, and still being able to do for them what's in their best interests.

Natkat, BSN, MSN, RN · Oct 25, 2006

Sometimes empathy is difficult. Sometimes it is impossible to put yourself in another person's place no matter how hard you try.

I think paraphrasing and reflecting are good. Some statements I've heard suggested are things like "that must be difficult for you" or "you have a lot of things happening to you." Maybe not the best choices but our instructor recommended them to us.

EmerNurse, BSN, RN · Oct 25, 2006

I agree with the other posters.

To me - empathy entails really trying to place yourself in your patient's position and FEELING what you would feel in their place. It's not easy but it can help you to understand why a patient might be resistant and might help you find the words to encourage them, like in the wound dressing example above.

Empathy can be a double edged sword though - if I fully empathized with every family who ever lost a loved one, I'd spend my entire shift in tears. That's where sympathy comes in. It's somewhat lesser in that you offer your sympathy for what they're going through, but you don't FEEL the feelings as such. Gads it's hard to explain.

Hope I made a shred of sense.

rn/writer, RN · Oct 25, 2006

Sympathy is the expression of caring feelings.

Empathy is being willing to experience those same feelings, even though this might cause personal pain.

Sympathy is more of a surface emotion.

Empathy lets the emotions in, lets them mean something even when those feelings are disturbing.

Sympathy says, "I'm here for you."

Empathy says, "I here with you. We'll deal with this together."

Sympathy can encompass pity, judgment, conceit, and even revulsion.

Empathy knows we are all "but dust" and has no pretensions that the suffering person is any less worthy.

Sympathy is conditional. Let the sufferer snap at the kind words or spurn the gestures and they are withdrawn.

Empathy gives grace and sees past the wretched behavior, never condoning abuse, but also never holding a grudge.

Sympathy secretly looks for reasons that they won't find themselves in this position--"I wear my seatbelt. I don't drink to excess. I don't cheat. I pay my bills. I'm a good person--as a refuge against fear.

Empathy submits to the knowledge that anyone anywhere at anytime can face something awful. It doesn't seek comfort in distance.

In your position as a student, you will come in contact with people who are messed up, funny, manipulative, intelligent, scary, threatening, nice, etc. After years of doing psych, I can tell you that they will be just like the rest of us only moreso. Whatever you run across in your everyday life, you will see in psych to a greater degree.

Two temptations crop up for those new to psych. One is to rush in with good intentions to spread kindness and caring to a population that is often judged and misunderstood. The other is to erect a mental barrier that separates "us" from "them." Patients provoke and manipulate the do-gooders and the naive. They can do the same to the "elite," but mainly they just don't respond.

What does empathy look like in a psych setting? For starters, it's humble, and the main expression of humility is a willingness to listen. When you talk to a patient, tell them who you are and ask if they would be willing to talk with you. Tell them this is a new area for you and you don't have a lot of knowledge. Ask if they would help you to understand what they are experiencing.

It's okay to be skeptical about what they say. Many psych patients have years of experience with clinicians and have become "treatment wise." They know what people want to hear. Or they will glom onto you and tell you that you are the only person who has ever made time for them and start enlisting you as an ally in their cause. Or they will actually be honest and give you good information. You never know what you're going to get.

The trick is to still connect with the person even when you have to hold what they say or do at arm's length.

Look for the human being "in there." Get past the diagnosis and find the person. Let yourself be upset and feel disturbed if need be, but choose to go where that person is and see what they see. Whether in psych or med/surg or ED or OB, this will not always be easy or comfortable. But empathy says, "Wherever you have gotten to, even if you're lost, even if you're stuck, even if you're destitute and dirty and really messed up, I'll find you there and come to you. And even if I can't help you very much because I don't have much to offer or you don't trust me or you don't like where you are but you're afraid to go anywhere else, I'll sit beside you and let you know you're not alone. And even if you snap at me and throw rocks, I'll forgive the words and sit just outside your throwing range and wave every once in awhile because no one should be abandoned when they're in pain."

It isn't always so dramatic. Sometimes it's just a cup of cold water on a hot day or a blanket on a cold one.

"Them" is "us."

leslie :-D · Oct 25, 2006

sympathy = feel for your pt.

it expresses itself intellectually.

you acknowledge their pain.

empathy = feel in your pt.

it expresses itself emotionally, personally.

you feel their pain.

leslie

zacarias, ASN, RN · Oct 26, 2006

Simply put, empathy is an being objective in your dealing with the patient. Sympathy is subjective

No matter how much we feel for a patient, we must maintain objectivity on the job which is in the patients' best interest; We must be empathetic. Sympathetic implies you're a little too involved in how they're feeling and can't honestly completely take care care of them in a healthy, objective way. The reason? Because with sympathy, you've crossed that line.

aggieamy5 · Oct 26, 2006

That is intertesting...I have never heard of empthay being defined as objective and sympathy being defined as unobjective or "crossing the line." Throughout my graduate training (Clinical Psychology) and in my field of work, empathy has been defined as putting oneself in another's situation or truly feeling what the other person is feeling, whereas sympathy is simply feeling sorry for another person or their situation. Carl Rogers, the founder of Person-Centered Therapy/Client-Centered Therapy, did extensive work related to empathy, unconditional positive regard, etc. Although it is vital to stay unbiased, it seems to me that someone that is truly empathetic could lose objectively just as someone who is sympathetic could.