Key To Renewal and Connection: Learn To Ride The Empathy Cycle

Physical therapists, despite our relatively high-level of job satisfaction, are experiencing increasing amount stress just like every other health care provider. We are also increasingly vulnerable to it’s adverse effects.

Unless you have a strategy to proactively manage the stress that comes from caring for patients with needs as well as dealing with needy people, you’re going to taste burnout, calcification, disconnection and loss of influence in some form or flavor.

For the “experienced” among us, you’ve likely felt these ill effects first hand or at least observed them in your colleagues. For those new to the profession then take notice. Regardless of how dedicated, accomplished or excited you are now, it’s not enough renew you and reconnect you with what matters most in the long run.


What’s the Antidote?

“Silver Bullet” cures are rare and when it comes to renewal and connection there is no exception. However, the literature does support applied empathy as almost a super power for both countering and reversing the ill-effects of stress in these two areas. Applied empathy is also key for building rapport and presence with anyone, including your patient.

British psychologist Edward Titchener used the German word “Einfuhlung” to describe empathy. It literally means to “project yourself into what you observe”. That’s more than just a feeling and requires action on the part of a provider. It’s also a far cry from sympathy, which is simply feeling sorry for someone. In fact, to experience maximum benefit, a provider must be “exquisitely empathetic”.


Be Exquisitely Empathetic

To be exquisitely empathetic is to be highly present, sensitively attuned, well-boundaried and have heartfelt engagement with another. This definition involves elements of cognition, emotion and compassion. Note the “well-boundaried” qualifier.   To be well-boundaried means to not become emotionally engrossed and over-identify with your patient; compassion fatigue and burn-out are two sides of the same coin.

When providers choose to interface with their patients in an exquisitely empathetic way, they not only are perceived as more caring, they have better outcomes, are happier and are better providers….and I would add better people as well.


How? The Empathy Cycle

So how do you deliberately “do” or apply empathy with another person? You learn to ride the empathy cycle, that’s how. Although it still takes intentional practice, it’s easier than riding a bike because it has 4 wheels instead of two. The challenge is that your not riding on a 1-way street and you have to navigate the road with the other person.

Barrett-Lennard described the empathy cycle in 1981 and the expand model has the following four steps that, while distinct, overlap and interlock with each other:

  • Empathetic Attention– Actively attending to the person and what they are expressing about their experience through their narrative. Curiosity and Active Listening are key tools for success.
  • Empathetic Resonance– You read and “resonate” with the person in a way that expressed aspects of her experience become alive, vivid and known to you. Both cognitive and affective elements are involved and mirror neurons are central to the process.
  • Expressed Empathy– You demonstrate, express, or communicate to the person in some way your felt awareness of what you experience from him. In a clinical encounter, this involves core meanings, sentiments and feelings communicated to you by the patient during the session, both in the moment as well as the overall sense.
  • Received Empathy– The person’s self-expression that you’ve felt them, both in extent and accuracy. The person may confirm it with what has been termed a “recognition reflex” (“Yes, that’s it!), which is a sign you’re complete on that particular thread or she corrects your empathetic response, signaling a need to revisit the issues.

The Empathy Cycle is an extremely effective influence technique and tool with much more detail than I described here. And while it’s useful with patients, coaching clients, and just about anyone else (including family), there’s an important caveat for it to work: it must always flow naturally from your genuine interest in the person you’re seeking to help.

What part of the empathy cycle, if you improved it just a little, would leverage your renewal, connection and ability to influence those that matter most?

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One response to “Key To Renewal and Connection: Learn To Ride The Empathy Cycle

  1. ADRIENNE says:

    Our nurses and care providers regularly practice a similar empathy cycle. We also have them practice self health care and self-help activities in order to avoid compassion fatigue.

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