Empathy….or Love?

Following on from the last blog on ‘The Taboo of Love’ I felt to explore one area specifically. The comments written after the last blog highlighted to me how there are so many areas of life where love is taboo. One commenter mentioned this in regard to her counselling training where they were not allowed to talk about love and said “So in a “so-called” helping profession it was suggested we don’t cross that bridge, rather let people stay in the confused mess, look as though we care, make sounds that sound like we care, but really offer no TRUE care and love, because we are not going to make it about love……CRAZY!” 

I couldn’t help but think how this applies also in the medical world and medical student training. I can pretty much guarantee that medical schools up and down the country and across the world do not talk about love in any form in their courses…..but what they do talk about, what they do put time and effort into teaching and assessing is …..EMPATHY.  So what exactly is empathy? And is it appropriate to teach it to medical students? Is there any potential harm in teaching empathy? Obviously there is a large body of opinion that feels it is very appropriate to teach it and indeed they would probably go further than saying it is appropriate but that it is an essential part of medical training and learning to be a compassionate doctor. Indeed the GMC’s view is that ‘every patient should be treated with empathy and compassion’.

Daniel Sokol wrote an article in the BMJ recently entitled “how to be a cool headed clincian” in which he questioned whether empathy was necessarily a good emotion for doctors to display. He was advocating the importance of ‘imperturbability’ rather than empathy and quoted William Osler telling medical students in 1889 that “in the physician or surgeon no quality takes rank with imperturbability” and that those lacking in it will quickly lose the confidence of their patients. Sokol feels that the current focus on empathy has rendered the “Oslerian virtue of imperturbability unfashionable”. 

However, he was subsequently criticised in the rapid responses for confusing sympathy and empathy and a number of clinicians emphasised the importance of doctors being empathic. The contributors variously described empathy as “a complex multidimensional concept that has moral, cognitive, emotive and behavioural components. It involves the ability to understand the patient’s situation from their perspective and communciate that understanding to them in a helpful way”, that “showing empathy is a natural response to another’s suffering and that it is not in the best interest of the emotional wellbeing of doctors to cut themselves off from their feelings in the mistaken belief that they will be better clincians”,  “to sense accurately and appreciate another person’s reality and to convey that understanding sensitively”, “an affective capacity to be sensitive to and concerned for another person and as a cognitive capacity to understand and appreciate the  perspective of another person”, to being able “to put ourselves in another person’s shoes(their situation, thinking, feeling meaning) and …..to communicate that understanding to our patient or colleague.”

The comments variously imply that without empathy it would be difficult to have warm rapport and relationships and that the doctor-patient relationship would inevitably be compromised along with their job satisfaction. The concern is that doctors would be cold and uncaring without empathy. Is this actually true??  What if empathy is not a healing balm for patient and doctor but a toxic emotion that drains the doctor and does not help the patient?? A strong statement perhaps but what if it is true??

Is it not a mighty presumption to think that we can know EXACTLY how another person is feeling and on that basis we are equipped to help them?? Something to ponder perhaps.

Is there possibly a different way to be with patients, that is not cold and uncaring, that assists the patient and does not drain the doctor? That keeps a cool head but has a warm heart?

From an esoteric perspective each person is known to have an essence of love, irrespective of the story they present to the contrary. Indeed, it is our ignorance of the fact that we are love, that is at the root of many of our ills and suffering. Our loveless liefstyles and behaviours over time take their toll on the body and bring forth many forms of suffering. This is a vast subject that cannot possibly be covered in one little blog. But the point for this blog is to understand that despite whatever is going on in our lives, whatever suffering we are experiencing there is a place inside each of us that is free from that suffering, that is unharmed by any abuse, torture, suffering of any kind,  illness or disease, that remains completely untarnished and is simply the purity of love. The more we get in touch with this place within ourselves, within our inner heart, this becomes a reality that is known and not just words that sound good or reassuring.  It alters how we see life, how we understand why things happen the way they do. It alters how we see ourselves and the choices we make.

What if we as medical professionals, indeed anyone in healthcare,  came to know this to be true for ourselves and thus true for our patients – that despite whatever they are going through there is a place within them that is unaffected by any of their suffering??  What if we could convey that to them just by how we are with them?? What if we were that loving, still presence in the midst of whatever turmoil they were experiencing and responded to them from that place that holds them as an equal in love?

Energetically this is healing for they get to feel that possibly there is a different way, that they are not that which they are currently experiencing, but are something more, something greater. Empathy does not arise them out of what they are in but merely confirms them in it, keeps them stuck in it and thus an opportunity for healing, for coming to a different understanding or a different way is lost. The more we live from that inner essence of love, the more we can be truly present for people in whatever suffering they are currently experiencing without taking on and getting affected by the emotional turmoil. We often have enough trouble dealing with our own emotions and issues without taking on another person’s stuff and energetically that is very draining for us.

However, by living from the inner essence of love we can develop that ‘imperturbability’ , to be that still point in the midst of chaos without being cold and aloof – to have that cool head and a warm heart. It is easier for me to write these words that I know for myself to be true than it is to live them at times. Being empathic has become so engrained after 20+ years in medicine that it is like being on automatic pilot and I can slip into it without even realising I am in it at times – even though I know it is not truly healing for the patient and is indeed draining for me also. However, I am more aware now when that happens and can take steps to address it. The more I live it, the easier it becomes for indeed it is about returning to our natural state of being, our essence of love.

I have also had the privilege of experiencing that way of being with patients, knowing they have felt met, listened to and honoured in the truth of who they are such that rather than being confirmed in the misery, they have been given an opportunity to feel they are more than that. I have in addition been on the receiving end of both empathy and true love whilst in the midst of an emotive issue and thus have felt for myself how empathy nauseatingly for me endeavoured to confirm me in something I’m not, whereas love gave me the opportunity to arise out of the issue and come to a new understanding – and that for me was healing. 

However, for me this continues to be a work in progress but one that I know benefits the wellbeing of my patients and myself. I was about to write that the reality of working in a busy hospital in the NHS and lifetime(s) of momentum of choosing otherwise, means that I do not consistently hold that way of being throughout each day – and yet I can also now feel how I use those as excuses, to keep the remaining loveless ways intact, to not be ‘there’ yet, to justify how I need to do more work on myself – rather than realising there is no ‘there’ to get to, just to be here simply breathing and being me, the true me. 

The German philopsher and poet Goethe said it thus: 

I have come to the frightening conclusion that I am the decisive element. 

It is my personal approach that creates the climate. 

It is my daily mood that makes the weather.

I possess tremendous power to make life miserable or joyous.

I can be a tool of torture or an instrument of inspiration.

I can humiliate or humour, hurt or heal.

In all situations it is my response that decides whether a crisis is escalated or de-escalated, and a person is humanised or de-humanised. 

If we treat people as they are, we make them worse. 

If we treat people as they ought to be, we help them become what they are capable of becoming. 

 

To treat people as they are, is to be empathic, to treat people as they ought to be is to hold them in the presence of love irrespective of what they present with and in that holding, they may arise to come to know that they are also that love already, without doing anything. 

Feel free to share your experiences of empathy either giving or receiving and /or your experience of being love, being you and its affect on those around you.