Empathy and sympathy: therapeutic distinctions in counseling.

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


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.


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


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


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


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


In the next example the counselor expresses empathic understanding

that is grounded in an immediate and extended apprehension of the


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.


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.


Dwayne Myers

Author: Dwayne Myers

Dwayne Myers is a 20-year-old health centre receptionist who enjoys worship, social media and helping old ladies across the road. He is stable and caring, but can also be very lazy and a bit moody.