The empathic process and its mediators: a heuristic model

Article Abstract:

Empathy refers to an ability to ''know'' the experience of another individual. Most empathy research has focused on psychotherapy or counseling situations. This paper presents a model which looks at the nature of empathy and identifies aspects or steps in the empathy process. Empathy is viewed as a process arising from an interaction between two people, and as a sequence of actions and reactions over time. The proposed model focuses on the first three phases of a five-phase empathy cycle, originally proposed by Barrett-Lennard in 1981. Each phase contains several mediating factors, which can influence the outcome of that phase. The first, or inducement phase, begins when a person observes another person who is expressing a feeling. This phase usually ends when the observer either becomes disinterested or overwhelmed. If overwhelmed, she or he may assume the other person has similar feelings and consequently feel pity. This response is described as sympathy, and is distinct from empathy. In phase two, the observer becomes engaged, is attentive to what is observed, and wishes to proceed with the empathy process. Then, a matching process begins in which the observer begins to feel for the person that is observed, via an ability to imagine situations which result in strong feelings which match the observed person's. The empathic process is continued only if this phase results in a wish to help. In the last, or helping phase, there are four possible outcomes: (1) the observer may wish to do nothing; (2) the helper may wish to be supportive but decide that doing nothing is the best way to help; (3) the helper may offer non-specific emotional support; or, (4) the helper may become actively involved in problem solving. (Consumer Summary produced by Reliance Medical Information, Inc.)

Models, Empathy

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Differential diagnosis and classification of apathy

Article Abstract:

Apathy can be characterized as a lack of motivation not due to a diminished level of consciousness, an intellectual deficit, or emotional distress. Correct psychiatric diagnosis should rule out other conditions which might simulate apathy, such as delirium, dementia, depression, abulia, akinesia, and despair and demoralization. Apathy can be classified according to whether it is a restricted or a pervasive feature of the adult personality; whether it has developed in conjunction with a reduction in perceived rewards in the person's immediate environment; and whether it is associated with a psychiatric or organic disorder, such as a neurological disease or injury. Accurate determination of whether apathy is present requires taking a careful psychosocial history from the patient, which should include socioeconomic, environmental, and medical factors. The existence of conditions such as poor thyroid function should be explored as should possible exposure to toxic agents. It may be especially difficult to diagnose frontal lobe disease. When a diagnosis of apathy has been made, treatment based on the cause can be instituted. Thus, if apathy results from an environmental cause, treatment would most appropriately be aimed outside the patient, and, hence, would not normally be performed by the clinician. Drug therapy directed specifically at apathy may be advisable when the condition is secondary to another disorder, such as schizophrenia. Learning more about the biochemical correlates of apathy can provide insight into the biological basis for motivation itself. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Apathy

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