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

http://j.mp/17vsghZ

• 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

• 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

• 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

• 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

• 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

  •