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Conferences on the Topic of Empathy
Empathy: The Development and Disintegration of Human Connection

2013-01-17 - Empathy: The Development and Disintegration of Human Connection
Symposium by the Center for Law, Brain, and Behavior - Massachusetts General Hospital



Helen Riess discusses "Empathy Research and Education"


Helen Riess MD, is Associate Clinical Professor of Psychiatry at Harvard Medical School and Director of the Empathy and Relational Science Program in the Department of Psychiatry at Massachusetts General Hospital.


  • 00: Empathy can not be over emphasized

  • We have a world empathy problem

  • going from micro to the macro

  • Can empathy be taught?  50%/50%

  • Testing of empathy by Marci

  • Person masking of pain

    • moments of extreme anxiety

  • 4:45 The empathy problem

    • empathy goes down in med school

    • not looking at the whole patient

  • 6:00 did study of empathy training

    • empathy could be taught - trained 800-1000 doctors

    • created online empathy training

  • 7:30 - Defining empathy

    • Martin Buber

  • confusions with

    • empathy - Em (in)  Pathos ( Suffering) understating emotions and thoughts

    • sympathy - Sym (same) sharing emotions, liking,

    • antipathy - Anti (against/avoid) disregard for another's suffering

  • a capacity to infer - can be positive or  negative ways

  • 9:45 - four components of empathy

    • cognitive

    • affective

    • behavioral

    • moral

  • 10:15 Evolutionary role of empathy

    • social context

    • understanding others

    • others actions

  • 11:00 cutting finger off - What do you feel?

  • 12:00 - parts of empathy in the brain

    • 13:45 Tania Singers pain matrix - where empathy lights up

  • 15:00 -  mirror empathy of faces

    • hearthmath - physiological responses

  • triggering and losing empathy

    • empathy and reflection - self awareness and mindfulness

  • E.M.P.A.T.H.Y. acronym

    • E - Eye contact

    • M - Muscles of Facial Expression

    • P - Posture/Position

    • A - Affect

    • T - Tone of Voice, Touch

    • H - Hearing the whole person

    • Y - Your response

  • Training - Rating of empathy

  • Cultivate Emotional Intelligence

    • Self Awareness

    • Self Regulation

    • Other Awareness and empathy

    • Relationship Management



Carl Marci discusses "Neurobiology and Physiology of Empathy"


Carl D. Marci, MD, Director of Social Neuroscience for Psychotherapy Research Program, Massachusetts General Hospital; Instructor in Psychiatry, Harvard Medical School

Physiology and Neurobiology of Empathy
Dr. Carl Marci will discuss aspects of empathic connection using the latest findings from hie research with peripheral measures of central nervous system activity.  Additional studies using neuroimaging to understand the latest in empathy research will also be presented.

The Look of Love - Love's many splendors begin with empathy and attachment


  • 12 month old children feel distress when they see distress in others

  • Three Perspectives on Empathy

    • 1. laughter and psychology

    • 2 neurobiology

    • 3. media

  • my journey through of empathy

  • 2:00 - (1). laughter and psychology

    • skin conductance (measuring empathy)

    • measurable effects

    • we don't experience emotions in our brain

    • embodiment of emotions

    • Measure the doctor-patient relationship

      • empathy scale - Barrett-Leonard Relationship Inventory Empathic Understanding Subscale

    • laughter is showing affect

    • laughing at the same time

    • Physiologic Concordance >get a window on empathy

    • empathy is incredibly fast - no real lag - almost instant - 50milsec

    • comparing the simultaneous scan of the patient and therapist

    • (can measure and compare the physical effects)

  • 15:00 (2). neurobiology of empathy

    • laughter brain circuitry

    • mirror neuron network

  • 19:00 (3). media

    • lower attention span


Alice Flaherty discusses "A Neurologist's View of Empathy?"


Alice Flaherty, MD, PhD, is a joint associate professor of both neurology and psychiatry at HMS. Her practice is at Massachusetts General Hospital. ]



  • about nonempathy

  • Intervention  ->  Empathy

    • Stereotype: surgeon  - >  psychiatrist

    • action oriented  - > don't do - sit there

    • more time pressure - > long relationships

    • goal of care are clear - >  patients goals not MDs

  • 2:00 How to preach empathy to the unconverted

    • things that don't help

      • med school empathy courses

      • voluntary seminars

      • most involuntary seminars

  • 3:00 Why do some doctors resist empathy?

    • Time

    • Money

    • Low affect tolerance

    • Perception of patient goals

      • why do patient like empathy?

        • it's a proxy for caring enough to do something to help the patient

      • why do we like empathy?

  • 4:40 Money: why is empathy not reimbursed?

    • anyone can do it  -

    • patients pay for concrete results -

    • empathy is imaginary  -

  • 5:45 Empathic imagination can mislead

    • feels like sense data but isn't

    • sensitivity and flightiness -

    • mass hysteria

  • 7:40 Empathy vs Sympathy

    • empathy = art jargon

    • applied to imaginary beings

    • useful for psychoanalysts

    • alienates interventionalist

    • postcolonial cultural critics

  • 9:50 Postcolonial critiques of empathy

    • observer's suffering replaces sufferer's emotions (sympathy)

    • false, smug sense of understanding

    • acts as placebo for real action

  • 10:00 Empathy for pain is painful

    • empathy is emotional work  (Larson 2005)

    • reverberating mirrors  (Flor 1995, Lang 2008)

    • affect tolerance not taught

  • 11:45 - Treatments for empathic pain

    • habituation (get  used to it)

    • dispassion as defense  (calm manner but patients cannot mirror doctor)

    • anesthetization

    • empowerment through action

  • 15:30 prosocial action eases empathic pain
    (feel more empowered in action)
    (empathy is a form of action)

    • prosocial action in medicine

    • Action decreases physician distress

    • Action eases patients pain

      • empathy vs. action: which do patients choose

  • acting and method acting - will burn you out.

  • 17:24  Empathy action link is complicated

    • does empathy drive action?

      • only briefly (Einolf)

      • holocaust rescuers (Oliner)

      • why don't' poets make good doctor

    • Or does action drive empathy

      • spinal cord lesions lower emotionality (Chwalisa)

      • chronic insensitivity to pain blunts empathy (danziger)

  • 18:00 Teaching empathic expression

    • observer perceptions are not enough

    • literature vs theater as the art of medicine

  • Dr House as representative of patent bias

    • lack of empathy as macho, competent, honest

  • 18:30  Social sensors for bedside manner

    • (doctors start turning autistic)

    • monitors doctors

  • Din Mirrors

    • first tune to patients emotional frequency

    • then dampens it's amplitude and redirect it

    • facilitates compliance



Judith Edersheim discusses "American Violence: The Absence of Empathy?"


Judith Edersheim, JD, MD is an Assistant Clinical Professor of Psychiatry at Harvard Medical School, a senior consultant to the Law and Psychiatry Service at Massachusetts General Hospital, and Co-Director of the Center for Law, Brain and Behavior.



  • Come from the world of extreme lack of empathy

  • Pure empathy

  • What does American Violence look like?

    • 1,200,000 acts if violence

  • Why so many homicides?

    • America worships violence

    • American social fabric disintegrating

    • many guns

    • promotion of violent video games and movies?

  • 8:00 myth busting - links to violence

    • substance abuse

    • psychotic disorder

    • psychopathy

  • 11:00 What causes extreme lack of empathy? violence

    • **1. societal lack of empathy. no safety net, torn social fabric

    • 2. familial lack of empathy contributes to violent propensities -substance abuse, etc.

    • 3. individual lack of empathy is a salient characterize of some violent criminal

  • 12:00 typologies of perpetrators: the lens of empathy

    • poor impulse control?

    • poor reality testing?

    • deficient empathy?

  • deficient empathy?

    • Loughner, Breivik, Holmes

  • Psychopathy- definition and about

    • Dexter

  • 16:00 Psychopathy a patient example

    • nature, nurture

    • hard to treat



Empathy: Panel discussion The Development and Disintegration of Human


WBUR's Martha Bebinger moderates a conversation between the panelists on how empathy varies between individuals, the neural basis for this capacity, and whether we should steer people with more or less empathic capacity to careers based on this capacity.
Helen Riess MD,
Alice Flaherty, MD, PhD,
Judith Edersheim, JD, MD
Carl D. Marci, MD



  • what are we doing wrong and what could we do right?

    • teaching of empathic behaviour

    • forums like this help

    • we're in the early days of empathy

    • rational models that don't work

  • we're noticing this way to late in life

  • Helen: need to lean it in kindergarten

    • need a relationship relationship

    • emotional circles in schools

    • have to teach it at all stages =- ages

  • Alice Flaherty: Instill empathy before it is to late - difficult to treat psychopathy.. keep it from happening

    • start easily - one thing that can take people off the psychopathy trajectory

    • can head of violence at the street level


  •  Is the empathic response uniform?

    • Judith Edersheim  - mirroring of emotion

      • people catch joy faster than sorrow

    • Carl D. Marci -

      • hard to measure empathic bandwidth

    • Helen: notice when your getting emotionally charged

      • body is like a musical instrument that is being plaid by others all the time

      • be mindful of that

      • emotional contagion (just catching) vr empathy (understanding)

  • Q and A

  • Doom and Gloom of Empathy? But Expanding Circle of Empathy expanding?

    • yes, things are getting better

    • better than what? lots of science happening

    • world of crime and violence

    • inequality in society

    • we are at the forfront of change

    • we have just scrached the surface of what can be done - need more research

  • 20:00 - How to stear students with their personalities toward approprient direction.

    • human brain is empathic

    • people have different capacities

  • 29:00 If empathy is a fatigable trait, is large population attributing to the empathy fatigue?

    • encouage converstations - in the home, education, etc,

    • embed in our own communities