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What's Empathy?

David Cohen has a PhD in clinical criminology and worked in forensic psychiatry for 28 years. He also suffers from chronic back pain.


Over the years many offenders enrolled in treatment programs told me that they were "learning empathy". When asked: "Whats empathy?" the most common answer was "to be in the shoes of our victim, to feel what they feel".

But really, no one can truly be in another person's shoes, even when in in a position similar to the shoe-wearer. Nor can anyone ever truly feel what the other person feels. In fact, many offenders found it frustrating that they could not really feel empathy the way it was taught, and out of frustration lost faith in treatment.

Neither Sympathy nor Compassion

Empathy is frequently confused with "sympathy" or "compassion". "Sympathy" is defined as: "Feelings of pity and sorrow for someone else's misfortune". "Compassion" is defined as: "Sympathetic pity and concern for the sufferings or misfortunes of others".

"Compassion" has a component which "sympathy does not: "concern", which entails some form of caring about the other person's feelings. However, neither compassion nor sympathy are empathy.

Empathy as a Mediator of Behavior

There are many different ways of defining or conceptualizing "empathy". Adam Smith, in his work The Theory of the Moral Sentiments published in 1759, defined "fellow feeling" (the word "empathy" didn't exist back then):

As we have no immediate experience of what other men feel, we can form no idea of the manner in which they are affected, but by conceiving what we ourselves should feel in the like situation ... by changing places in fancy with the sufferer... we come either to conceive or to be affected by what he feels...

According to this definition, empathy entails: 1) noticing what the other feels, and 2) "conceiving" what we would feel if we were in the other's place. There is no behavioral component.

B.S. Moore, in his 1990 paper: "The origins and development of empathy" also emphasizes that empathy necessitates noticing something in the other and having an emotional reaction, but adds:

Empathy has long been considered to be a mediator of various forms of pro-social behavior. Indeed, a number of theoretical accounts of altruism have suggested that it is necessary to turn to emotional role-taking upon the part of the altruist to explain the motivation to engage in self-sacrificial behavior

An Operational Definition of Empathy

Bill Marshall and his colleagues, in their 1995 paper: "Empathy in Sex Offenders", propose that empathy is a four-stage process.

  1. Emotion recognition: The ability to discern the other's emotional state. This includes looking at and / or listening to the other person, and trying to understand (actively, if it doesn’t come naturally) what he or she is feeling. For example, if one person is hurt, another person won't realize that unless he looks at the other's face or listens to him. One must also understand that (for example) tears and sobbing indicate distress.
  2. Perspective-taking: Seeing the situation, as best you can, from the other person's point of view. Perspective taking is not "feeling what they feel". Rather, it is an attempt to try and identify with the other, to form some kind of bond with them, to imagine similarities between them. Many people with problems experiencing empathy see others as objects, or as "foreign" or "strangers". While they can identify another's distress, they just don’t care. "Perspective taking" facilitates the third step:
  3. Emotion replication: Emotional replication entails finding and recognizing in one's self the emotion present in the other.
    The last part of the process, which can only come, according to Marshall, after the first three have been accomplished, is
  4. Response decision: Act on what you see, understand and feel.

For example: A man and a woman are talking, and all of a sudden the woman starts to cry. Empathy on the part of the man would entail:

  1. Notice the crying and understand that this indicates distress.
  2. Understand the situation from the her point of view ("wow, she's really hurt, maybe I shouldn't have said that").
  3. A commensurate feeling in the man ("She's really upset. Now I feel bad").
  4. Appropriate behavior: There are several things the man can do, among them: Yell and berate the woman for making him feel bad; run away out of shame; apologize and ask what he can do to make it better. Only the third behavior is empathic.
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Empathy doesn't Always Come Naturally

In my work with abusive men, I have found that many get 'stuck' on the first step. They are so engrossed in getting what they want, and so out of tune with the person they're with, that they just don’t bother to pay attention.

In many such cases, teaching them to be aware of the other, to look at the other, listen and ask the other what they're feeling, is enough. These offenders can identify emotions if they try, but they need to be taught to try. Usually, once they learn that, the other steps come naturally or easily.

Perspective taking is more abstract and more difficult. In many cases, if an abuser is shown pictures portraying various facial expressions and asked a question like: "which one of these has just heard that a loved one died"? they won't know. Ask which has the same expression as their victim, and which portrays distress, they will probably know. But they can't make the transition to understand emotions from another's perspective. It is very hard to "teach" perspective taking, and it may require long term therapy.

Marshal et al write that the first three stages must be present in order to get to the fourth. However, in my clinical work I have noticed that , many people who have problems with emotion replication can still move on to the fourth stage.

Many people not capable of emotion replication can understand the idea: "this person is in distress, something must be done". In our therapy sessions, we called it "caring". It is possible to teach offenders who "just don't care" to respond empathically to another's distress- although in some cases this entails a long treatment process

Deficits in the fourth stage of empathy are the most serious. I have seen patients who can identify others' emotions, see that they are in distress and from what, and despite feeling a tinge of excitement, know that they need to react in a socially acceptable way (which may be nothing more than backing off). Many of these are offenders who have successfully completed some type of treatment and learned to control their impulses and desires. They really do care- they just don't experience emotions the way others do.

However, There are some cases in which after identifying another's distress a person will feel excited or aroused. Such cases are relatively rare, and people who display this tendency may be resistant to conventional treatment methods.

There are also those who see the other's distress as an opportunity. Some may even seek out weak as preferred victims. In fact, Book, Quinsey and Langford have coined the term "callous empathy" to describe "the lack of feeling for others while exhibiting definite understanding of their mental states by using the information to their own ends". People who exhibit such traits may be true predators and suffer from a severe personality disorder and / or may be unable to benefit from treatment.


Empathy is a four stage process: 1) Identify what the other feels: Look, listen, ask if necessary. 2) Try to understand the situation from the other's point of view: Think, what made the other person cry and show distress. Ask, if necessary. 3) Feel, as best you can, something commensurate with what the other person felt. For example feel bad because you hurt someone. Feel good because you made them laugh. Or, at least, if you don't feel, care. 4) Act in a way that will help the other. Don't start yelling; don’t run away (unless that is truly the most adequate response) don't use the other's distress to facilitate hurting them.

Proper empathy is directed towards identifying and trying to lessen another's pain (or not cause pain, or not "burst their bubble" when they're happy). Unless all four aspects, including the final behavioral one, are present, there is no proper empathy.


Book, A. S., Quinsey, V. L., & Langford, D. (2007). Psychopathy and the perception of affect and vulnerability. Criminal Justice and Behavior, 34(4), 531-544.

Moore, B. S. (1990). The origins and development of empathy. Motivation and Emotion, 14(2), 75-80.

Marshall, W. L., Hudson, S. M., Jones, R., & Fernandez, Y. M. (1995). Empathy in sex offenders. Clinical psychology review, 15(2), 99-113

Smith, A. (1759). Theory of moral sentiments. London: A. Miller Press.

© 2019 David A Cohen

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