Re-examining empathy: a relational-feminist point of view.

For thousands of years people have been aware of the concept of empathy. In ancient Greece, philosophers expressed their understanding of "empathy" by the word empatheria, which implies an active appreciation of another person's feeling experience (Astin, 1967). In 1910, British psychologist Edward Titchener translated the German word "Einfuhlung" into empathy, literally meaning "to feel oneself into" (Bohart & Greenberg, 1997). In the 1950s, American psychologist Carl Rogers highlighted the importance of empathy in his client-centered approach to working with people. His description of empathy was widely adopted by social workers, giving common voice to its meaning in professional literature. According to Rogers (1951),

 
   it is the counselor's function to assume, in so far as she is able, 
   the internal frame of reference of the client, to perceive the 
   world as the client sees it, to perceive the client himself as 
   he/she is seen by himself, to lay aside all the perceptions from 
   the external frame of reference while doing so, and to communicate 
   something of this empathic understanding of the client. (p. 348) 

Although empathy may be used differently in different models of practice and in different practice settings, current social work scholars consistently identify the concept of empathy as one of the critical ingredients in constructing a helping relationship in which the client feels understood and sustained by the worker (Hepworth, Rooney, Rooney, Strom-Gottfried, & Larsen, 2006; Shulman, 2006). Furthermore, empirical studies have demonstrated that empathy has been closely correlated with effective outcomes in social work practice. For example, Truax and Mitchell (1971) have shown that the failure to empathize with clients is a key error that leads ultimately to the client's premature withdrawal from the helping process.

More recently, a review of 52 child psychotherapy treatment studies by an eminent university research team compared treatment groups containing "active" therapeutic interventions with those not containing active therapeutic interventions. The authors suggested that "nonactive" or "nonspecific" relational elements such as empathy, attention, and positive regard likely account for the great deal of unexplained variance in intervention outcomes. They concluded that these neglected variables are not only a necessary threshold for treatment efficacy, but may well be essential to enhancing it (Jensen, Weersing, Hoagwood, & Goldman, 2005).

Perhaps because nonspecific relational factors are difficult to control in looking at indictors for change, the concept of empathy has received relatively scant attention in contemporary social work literature (Raines, 1990). The purpose of this article is to elaborate on the meaning of empathy and its role in the helping process in light of recent developments in feminist scholarship. Through the lens of relational-cultural theory--a new relational paradigm for practice originating out of the Stone Center for Clinical and Developmental Studies at Wellesley College--empathy is re-examined for effective social work practice. Relational-cultural theory, written from the standpoint of the life experiences and developmental processes of women and girls, moves social work beyond the more traditional unidirectional definitions of empathy suggested in social work literature, to a framework that conceptualizes empathy in an increasingly mutual, interactive, and humanist way.

Relational-cultural theory evolved out of the work of feminist theorists such as Carol Gilligan, Nancy Chodorow, Mary Belenky, and others: work written by women about female growth and development based on clinical studies and observations of girls and women's life experiences. The relational-cultural approach applies these developmental theories to practice and is concerned with certain growth-fostering relational activities that are vital to the health of all human beings. The relational-cultural model represents an organic outgrowth of feminist relational theory reflecting a growing awareness of the impact of culture and power practices within a larger sociocultural context (Jordan, Walker, & Hartling, 2004). This article uses the terms "feminist relational theory" and "relational-cultural theory" interchangeably

EMPATHY IN THE PROFESSIONALIZATION OF SOCIAL WORK

Notable social workers writing at the turn of the 20th century, such as Mary Richmond, invoked the importance of sympathetic understanding of clients, which she clearly differentiated from what she considered to be the intrusive efforts of the friendly visitors of the earlier charity organization movement (Richmond, 1922). In their vital need to be recognized as a legitimate profession, social workers were influenced by Freudian theory and Freud's "dynamic" passive technique as a way to establish a more scientific approach to social work practice (Hartman, 1972). An understanding of empathy and its application in the traditional casework setting was seen as a way of tuning into the unconscious or subconscious thoughts and feelings of which the client may or may not be aware. Psychodynamic theorists noted that empathy inferred that the worker did not simply take a client's word at face value, but searched for the deeper meaning in the cognitive and affective signals that the client transmitted (Woods & Hollis, 1999). For example, Mrs. A, a 40-year-old client, talks about her divorce with depressed affect and tears in her eyes. The worker says, "I hear how painful it is for you to talk about your divorce and the loss of your husband. It sounds like you feel quite betrayed." In this traditional approach, the worker uses empathy to reflect on, and gain insight into, the person's feelings and inner state of mind by passive listening. Freud called this "evenly suspended attention" (Freud, 1921/1955, p. 109).

Post-World War II social work leaders representing the diagnostic school, such as Gordon Hamilton (1940) and Florence Hollis (1964), directed attention to elements associated with empathy--acceptance, understanding, expectation, and support--in an effort to gain better insight and deeper meaning into another's mind. This concept of empathy offered professionally trained social workers a way to distance themselves from the ordinary lay term "sympathy" and to strengthen the social work relationship. In the 1940s and 1950s, members of the functionalist school, such as …