At various times in the treatment process, mental health counselors
may inadvertently equate the concepts of empathy and sympathy This
confusion is” understandable because there is ambiguity between the
two terms that could contribute to miscommunication in counseling. This
article clarifies the therapeutic distinctions between empathy and
sympathy through the dimensions of aim, appraisal, apprehension, and
agreement.
As expressions of caring and compassion, empathy and sympathy are
sometimes confused by mental health counselors and may mistakenly be
equated (Chismar, 1988). Although both involve attempts by a counselor
to sensitively respond to what a client is experiencing, there are
qualitative differences between the two processes that have therapeutic
implications (Clark, 2007). Blurring the distinctions and failing to
differentiate empathy from sympathy may contribute to misdirections in
the treatment process.
Empathy offers a way for a mental health counselor to grasp the
feelings and meanings of a client and convey this understanding to the
client (Myers, 2000; Pearson, 1999). In contrast, sympathy is important
in human relationships as an expression of concern or sorrow about
distressful events in a person’s life (Meier & Davis, 2008).
In the counseling and psychotherapy literature, empathy is widely
recognized as a prominent variable in the development of a positive
treatment relationship
Arthur J. Clark is affiliated with St. Lawrence University.
Correspondence concerning this article should be addressed to Professor
Arthur J. Clark, Coordinator, Counseling & Human Development
Program, St. Lawrence University, 23 Romoda Drive, Canton, New York
13617. E-mail: aclark@st.lawu.edu.
(Norcross, 2010; Lambert & Barley, 2002). In terms of the
importance of the therapeutic alliance, Ridley and Udipi (2002) found
that the quality of the client-counselor relationship was the most
significant discriminating factor for predicting treatment outcome. With
varying degrees of emphasis, empathy is endorsed and practiced in
counseling across a diverse range of contemporary theoretical
orientations (Clark, 2007, in press; Cochran & Cochran, 2006).
Although the use of empathy is broadly supported in counseling, it
is essential for a counselor to be aware of both its strengths and its
limitations (Feller & Cottone, 2003; Kohut, 1982). In particular,
empathy is subject to misuse when a counselor semantically confuses
empathy and sympathy. The uncertainty is understandable because in
research, as in everyday life, lack of specificity in the meaning of the
two terms can contribute to treatment misapplications (Aring, 1958;
Gruen & Mendelsohn, 1986). The purpose of this article is to
differentiate between and clarify the functions of empathy and sympathy
in counseling.
THERAPEUTIC DISTINCTIONS BETWEEN EMPATHY AND SYMPATHY
Through the consideration of four comparative dimensions in the
counseling experience–aim, appraisal, apprehension, and agreement–it
is possible to distinguish empathy from sympathy.
Aim. In counseling, the primary intent in employing empathy is to
express understanding of a client, whereas the focus of sympathy is a
client’s well-being in difficult or challenging circumstances
(Black, 2004; Wispe, 1986). Empathy emphasizes an active sharing by the
counselor of what a client is experiencing while maintaining some level
of emotional detachment. In contrast, a counselor’s sympathetic
response has the more circumscribed function of expressing compassion
for an individual’s distressful condition or situation (Eisenberg,
2000; Olinick, 1984).
In a counseling example, Stanley, 46, an electrical engineer,
expresses feelings of anger and dismay over the possibility of being
relocated by his company. He has been an employee at the same
manufacturing site for 12 years.
Stanley: I can’t believe it. Because of my job, there is a
possibility that I will have to move with my family to another part of
the country. I’m so upset. I don’t even want to talk about it.
Counselor (Sympathy): I am so sorry to hear this. Why don’t we
talk about something else that is less upsetting for you?
In reaction to the client’s distress, the counselor
demonstrates sympathy as a caring gesture by offering to change the
topic of discussion. In this instance, it is not the initial expression
of sympathy that is the problem (“I am so sorry to hear
this”). It is the fact that the counselor then changes the focus of
the session away from the essential issue in order to sympathetically
protect the client’s well-being and alleviate his immediate
discomfort.
In the next example, the counselor communicates empathic
understanding by acknowledging what the client is experiencing in a
purposeful and sensitive way that may prompt him to continue discussing
the troubling topic.
Counselor (Empathy): This is hard for you to talk about, and it
doesn’t make any sense to you. The prospect of this change seems
overwhelming to you at this point.
Certainly, a counselor can get caught up in the feelings of a
client in employing either empathy or sympathy. However, as a counselor
strives to empathically understand what a client is experiencing while
maintaining emotional detachment, this posture potentially provides a
broader perspective that extends beyond a client’s situational
distress. Accordingly, the counselor’s empathic understanding may
at times evoke a therapeutic direction in the longer-range service of
the client.
Appraisal. A counselor’s empathy entails attunement with a
client’s feelings and meanings (Gruen & Mendelsohn, 1986;
Pearson, 1999). Through a subjective process, a counselor may appraise a
client’s functioning by identifying with the person on a transitory
basis (Clark, 2007, 2009, in press). In contrast, rather than involving
a sharing of experiencing, sympathy instead proceeds from a
counselor’s judgment of a client’s emotional needs. Sympathy
is thus a reaction to a client’s distress that becomes manifest in
mild to intense expressions of feelings of sorrow for the plight of an
individual (Gribble & Oliver, 1973; Switankowsky, 2000). A counselor
may say, for example, “I’m sorry to hear about your recent
loss of your cat.” It is appropriate for the counselor to
communicate this authentic response, even without a full understanding
of the client’s feelings toward the cat. In other instances,
however, a counselor may express sympathy in a way that excessively
focuses on his or her appraisal of the client. Judgmental statements,
such as “You sure have it rough,” “It pains me to see you
going through all of this,” or “This is a terrible thing for
you,” involve an evaluation that primarily reflects the
counselor’s perceptions.
To continue with the example, Stanley begins to disclose more about
the potential effect of moving on his family if he has to change jobs.
Stanley: What this means is that my two kids will be uprooted and
have to move over a thousand miles from home. I’m worried sick
about what this would do to my children.
Counselor (Sympathy): That’s so sad. There are so many things
you are worrying about right now. 1 feel very badly for you.
This response overemphasizes the counselor’s personal
appraisal of Stanley’s situation and diverts the focus of the
session away from the client. The one-sided line of discussion also
inhibits momentum in moving forward with the therapeutic conversation.
In the next statement, the counselor expresses an empathic
understanding of the client in a more balanced way that may prompt
further discussion.
Counselor (Empathy): This move involves a major change in the lives
of your children, and it creates uncertainties that are troubling for
you.
Although the examples set up a best case situation for empathy and
a worst case for sympathy, counselors need to be aware of the
possibility of overemphasizing their own reactions when expressing
either response. Attempting to accurately evaluate a client’s
perceptions often facilitates a more open exploration of therapeutic
issues.
Apprehension. A deeper way of knowing an individual is more likely
to occur when a counselor attempts to empathically understand a client
from multiple perspectives (Clark, 2002, 2004, 2007, 2009, in press).
For instance, through their identification and imaginative capacities
counselors can subjectively apprehend what clients are experiencing.
From a different perspective, counselors may employ an interpersonal
modality by striving to grasp the verbal and nonverbal communications of
a client (Rogers, 1975). In contrast, when expressing sympathy it is not
necessary for a counselor to “enter into” a client’s
experiencing or to have a deeper knowledge of the person in order for
the process to be effective (Gribble & Oliver, 1973)–a counselor
may only have a general understanding of a client’s plight but
still be able to be sympathetic.
However, in other instances, if a counselor does not more fully
apprehend a client’s experiencing and expresses sympathy in a
perfunctory or superficial way, misdirections may occur. That is why
highly sympathetic expressions, such as “I was a teenager once, and
I know what you’re going through” or “I went through a
divorce, and I know how you feel,” are often rejected because
clients see them as presumptuous or shallow. Further, unless the
counselor has a deeper understanding of a client, it is possible for the
client to construe some sympathetic comments, such as “You have an
inner strength that you can always call upon” or “Things will
improve in time,” as trite or too generalized to be valid. Although
it certainly is possible for a counselor’s employment of empathy to
be inaccurate, apprehending a client’s functioning from multiple
perspectives frequently enhances empathic understanding.
In a continuation of the counseling example, Stanley discusses how
he was informed about the relocation plans within his company.
Stanley: I can’t believe how they told us about it. Last week,
the higher-ups gathered us all together in a room and said that a number
of employees would be reassigned to another plant. A couple of hours
later, my supervisor told me I was on the list of people who would have
to move. What an insult! I’ve given my heart and soul to my job.
Counselor (Sympathy): That’s really unfortunate, and I know
exactly how you feel. Once when I was in the service, I was called into
an office and told that I would be deployed within a month to a new post
in a different part of the country.
Although the self-disclosure of a counselor could contribute to
therapeutic gain, the technique may prove to be ineffective when
counselors assume that their own experience matches or equates to that
of the client (Egan, 2010; Ivey, Ivey, & Zalaquett, 2010). It is
possible, for instance, that Stanley perceives the counselor’s
disclosure as focusing more on the needs and personal perspectives of
the counselor. Also, for any number of reasons (the counselor was
single; the counselor was young; or that’s the way it is in the
service), Stanley might dismiss or reject the counselor’s
disclosure.
In the next example the counselor expresses empathic understanding
that is grounded in an immediate and extended apprehension of the
client.
Counselor (Empathy): It hurts to be treated this way when you feel
that you’ve been a devoted employee for so long.
Apprehending a client’s subjective functioning, as in the
illustration with Stanley, often involves an attempt to grasp the
experiencing of the person within a broader context. Although a
counselor may be less than accurate when employing empathy, striving to
empathically understand a client’s experiencing in a cultural
context often lessens this possibility (Miville, Carlozzi, Gushue,
Schara, & Ueda, 2006; Ridley & Udipi, 2002).
Agreement. A counselor’s accurate and appropriate use of
empathy involves expressing an empathic understanding without implying
agreement with the client. In contrast, in expressing compassion and
commiseration, it is possible for a counselor to sympathetically convey
agreement with the views and perspectives of a client (Egan, 2010). With
the intent of alleviating distress a counselor may side with a client
and support the person’s point of view (Szalita, 1976). As an
unintended consequence, however, the counselor’s perceived
agreement with a client may subsequently hinder the exploration of
alternative perspectives. It is also possible for a counselor to agree
that a client should feel bad, angry, or even hopeless, and this
implicit endorsement can contribute to the client’s assuming a
victim role (Knapp, 2007).
Continuing with the counseling example, Stanley relates additional
information about his job relocation:
Stanley: I’m so ticked off about work. This week it got even
worse because I found out that unless I take the position in the other
plant, I could lose my job altogether. I was informed about this in an
e-mail rather than face-to-face. I’m about ready to tell them all
where to go.
Counselor (Sympathy): What a terrible way to treat you. How much
more can you be expected to take? 1 don’t blame you for being angry
and wanting to tell them off:
In this interaction, the counselor intensely affirms the
insensitivity of the message; however, it also makes it difficult for
Stanley to reverse his confirmed choice without losing face or appearing
inconsistent and weak.
In the next exchange, the counselor empathically responds to the
client’s communication without implying agreement. The counselor
also conveys a more balanced and open reaction that seems to capture the
client’s meaning.
Counselor (Empathy): The prospect of having to either move or lose
your job is even more painful for you when your supervisors seem to act
in an impersonal way about it.
A counselor’s undue expression of sympathy may negatively
influence a client by appearing to agree with the client. Agreement with
a client may have the detrimental effect of foreclosing the exploration
of therapeutic issues.
SUMMARY
When a mental health counselor equates empathy and sympathy, this
confusion may contribute to misdirections in counseling. Empathy is a
prominent factor in promoting positive treatment outcomes; sympathy has
an essential role in human relationships. It is possible to clarify
distinctions between empathy and sympathy through the dimensions of aim,
appraisal, apprehension, and agreement. A counselor’s awareness of
the appropriate use of empathy and sympathy has potential to foster
therapeutic gain.
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Arthur J. Clark is affiliated with St. Lawrence University.
Correspondence concerning this article should be addressed to Professor
Arthur J. Clark, Coordinator, Counseling & Human Development
Program, St. Lawrence University, 23 Romoda Drive, Canton, New York
13617. E-mail: aclark@st.lawu.edu.
https://www.thefreelibrary.com/Empathyandsympathy:therapeuticdistinctionsincounseling.-a0225791691
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