Empathy: Theory and Application in Psychotherapy

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Empathy is a term much used in popular culture and professional circles. Yet it remains one of the most misunderstood tropes. Most people confuse or conflate empathy with sympathy; though related, these involve somewhat radically different affective or psychological registers. Empathy is founded on the art of understanding a living being's particular mental state or inner condition, in respect of his /her predicament, pain, suffering, anguish, fear, grief, sorrow, frustration, and anger in certain trying circumstances. There can even be comportment with another's joy and exhilaration. Its proper use makes possible a much deeper understanding of human communication, relation, intentionality, and action. As such empathy has its cognate in the Eastern or contemplative practice of compassion (koruna, metta, k pa) toward another, and also to sorge or "care" in phenomenological hermeneutics. Thus, there are cognitive, affective and ethical components in the practice of empathy. The importance of empathy whether in everyday life or as a clinical tool in therapeutic and palliative settings cannot be more emphasized. The book demonstrates the way in which using empathy as a means of diagnosis leads to different, more successful results and course of action. In so doing, the study challenges the erstwhile neglect and misconception of the role of empathy in transference and introspective processes availed in psychoanalysis.

The book introduces novices in the field to the rich literature of psychoanalysis and philosophy, combining conceptual phenomenology with empirical data collected in a clinical setting. Testing the theory against clinical cases, as the book engages with, lends itself to a more solid conceptualization that can be poignantly articulated and studied further. The book will benefit students and practitioners in counselling, social work, psychiatry, psychoanalysis, psychotherapy and philosophy.

Renuka Sharma, formerly of the University Melbourne and Monash Asia Institute, Australia, was trained in medicine, psychiatry, and psychotherapy. She continued her practice in medical and psychoanalytic counsellimg, while pursuing further studies in emotions, feminist philosophy, and ethics-which were curtailed due to her premature demise in 2002. A formidable worker and thinker, she left behind a legacy as an engaged social phenomenologist in Australia India, and the US.

Renuka sharma passed away prematurely at age forty-four on October, 31'1, 2002 in Melbourne, Australia, after struggling with a pernicious form of terminal cancer over a protracted period, part of which she also spent in temporary residence in the United States and as well as in India. She was in her prime, professionally and in personal life.

The present book, as she describes in her Preface to the original edition, arose in a more general way during her training in medicine and in psychiatry, but more specifically in her training in psychoanalysis and her practice as a feminist psychotherapist. More concretely, the pages of the book emerged from a felt need to expand on her earlier paper on "Empathy" which was published in the Australian and New Zealand Journal of Psychiatry in 1992 in tandem with her higher- studies work towards a Masters in Psychological Medicine (and later Ph.D. thesis on Emotions and Affectivity, which remained incomplete due to the onset of the irreversible health challenge).

The work was hailed by her peers as marking an original contribution, that set out admirably toward tackling the formidable array of problems posed by empathy in the philosophical, clinical and social domains; it was deemed that the work should become an important stimulus for debate and creative thinking to guide and clarify future explorations associated with the concept of empathy. Hence an effort was made towards the publication. The book has long been out of print, and not widely accessible.

In the tenth year marking Renuka's demise, as her surviving partner and intellectual companion, I undertook to re-issue the book. In this effort, I was assisted by a number of friends and colleagues. Karin Brown (my philosophy colleague from San Jose State University's Comparative Philosophy team) kindly agreed to write a new Introduction, not least from the point-of-view of updates from recent work in the area and some connections she sees between Renuka's thinking on empathy / compassion with phenomenology and feminist thought. Patrick Hutchings, Sherah Bloor, Peter Wong and Amy Rayner at the Sophia Projects office encouraged me to proceed with the task - especially after the powerful evocation that Patrick offered at the funeral services, cited in the obituary by Max Charlesworth - another source of inspiration to Renuka - that appeared in the "The Age" (Melbourne) 30.12.2002.

Brightness, radiance, luminosity are the exact words for the spirit of Renuka Sharma, who continued to work on empathy, emotions, ethics, gender and justice even in the midst of frantic travelling and aggressive treatments.

Hazel Rowley (before her premature demise also in 2011), Tina M. Benson and Liza Lichtinger (Bay Area/SF-based Optimal Psychotherapists) read the first edition and gave me some helpful feedback. While Renuka's favourite Devi (of the canine kind) is also no more, her (Devi's) daughter Rasa is still in the care of their long-appointed nanny, Nina Ruhle. Together they exude and remind one irresistibly of the aura of empathy and much mirth that surrounded the Sharma- Bilimoria family-homes in Camberwell (Melbourne) and in Venus Bay (Victorian seaside) during the days of intellectual and cultural creativity: a moment that has all but slipped away into the darkened mirror of her story.

The significance of understanding empathy cannot be overemphasized. In this study Dr Renuka Sharma shows how empathy can provide insight into another person's mental states, not accessible otherwise. Viewed from this perspective, empathy can be used as a clinical tool in a therapeutic setting. Sharma well shows the way in which using empathy as a means of diagnosis led her to a different, more successful course of action. Thus, there is an epistemological and an ethical component in practising empathy. The interest in empathy spans across disciplines, and studying empathy promises a deeper understanding of human communication, relations and action.

Sharma first provides a thorough historical and etymological account of the origin and uses of the term "empathy" in various disciplines. She then proceeds to discuss the literature on empathy in psychoanalysis. There is no shortage of literature defining empathy which Sharma carefully surveys to provide the reader with an up to date map of the issues in professional literature. Sharma fully explains the extent and limitations of the material available. She notes that the research is insufficient and consequently the definition of empathy available is unsatisfactory. The emphasis in psychoanalysis is on the affective aspect of empathy, and yet because empathy is a tool to inquire into the life of another, a satisfactory account of empathy must be predominately an epistemological one. Even though empathy' does seems to play a role in various therapeutic stances, it is not sufficiently differentiated from other psychoanalytic terms such as identification, countertransference, projection, introjection and projective identification. Last, there are also challenges in studying empathy as the concept can be ellusive scientifically. Sharma is in a unique position to approach the topic. Familiar with both the literatures in psychoanalysis and philosophy, she takes an interdisciplinary approach, combining a conceptual analysis mainly drawing from phenomenology with empirical data collected in a clinical setting. The clarity with which she is able to formulate the mechanism of empathy and her access to clinical cases lend itself to a more solid theory that can be articulated and further studied.

First we turn to the foundation of this study, the conceptual framework for understanding empathy where the author’s originality and significant contribution to this field lie. The question is clearly raised: given that there are boundaries between self and other, between subject and object, how does empathy provide an epistemic understanding of the reality of the other? Sharma is successful in answering this question in locating empathy in intersubjectivity, to which we turn next.

**Contents and Sample Pages**