January 16, 2013

Capacity for Empathy

How come sometimes you can listen to a colleague complain or to a friend vent for hours on end, never wavering in your sympathy, empathy, or active listening skills--but on other occasions, your patience wear thin after minutes?

Last fall, I posted about our capacity for composure, suggesting that composure is a limited and fluctuating resource dependent on physical comfort, mindfulness and the intensity of our stressors. Since then, I've been thinking about empathy--the often (but not necessarily) sympathetic identification with or experiencing of another person's thoughts, feelings and experiences. Empathy is a key component of friendships and of patient-therapist relationships, and a resource that may also be fluctuating and limited in nature.

For example, consider the time I lost my patience with my friend who kept repeating herself and unwisely retorted "I get it, already!" Not exactly empathetic! In retrospect, I can identify that it was the last week before the Christmas holidays and that we were spending the evening together after a long day of back-to-back therapy patients. That is, my capacity for empathy was low.

I was once on the receiving end of a breach in empathy on the part of my own therapist: I was complaining about something I wanted but felt was impossible to have and my therapist lost his patience and snapped something like "Can't you see that what you're looking for is right in front of you? Open your eyes!" I was pretty taken aback at the time but when I later learned that he had received some extremely distressing news about five minutes before our session, I understood a bit better. My therapist's capacity for empathy was very low during our session; otherwise impeccably appropriate, he slipped up and said something unhelpful and out of place.

For therapists and lay listeners alike, capacity for empathy seems to depend on a few things. First, similar to capacity for composure, having your basic physical needs met is key. It's hard to listen helpfully to someone else's problems when you're starving, exhausted, or have a raging headache. Second, capacity for empathy suffers when there's too much demand: if your best friend's marriage is breaking up and your sister just lost her job, you might not be a very good listener for your colleague who wants to discuss his toddler's bed-wetting. Third, it can be difficult to have empathy for others if you're having your own problems. If you were just diagnosed with a serious illness, your capacity to empathize with a friend's existential angst is probably pretty low.

Therapists need a pretty endless supply of empathy. To maintain capacity for empathy, in addition to attending to our basic physical needs, we need peer support (i.e., don't work all alone all week in your private office with no one to provide social interaction or peer support) and should avoid scheduling too many patients in one day, or too many patients in a row without a break. Further, awareness of how our personal lives are affecting us will allow us to monitor and minimize the impact on our work. Keeping these tips in mind can help us avoid exhausting our empathy reserves.

For non-therapists, the tips for maintaining the capacity for empathy are no different: in addition to making sure your basic physical needs are met, don't spread yourself too thin empathy-wise (e.g., if you spent the morning consoling your sister over her job loss and your friend calls to discuss his relationship woes, you might want to limit the length of the conversation or call him back later). Remember that your empathy reserves may be low if you're dealing with your own serious problems, and feel free to hoard most of your empathy for yourself during those times. Keeping these tips in mind can help you avoid breaches in empathy and maintain your reputation as an empathetic listener.


  1. i have a question: what research have you read about hiw many patients per day is "reasonable" for a cbt therapist?

  2. Hi Bo,

    I haven't read the research in this area. To date, I think the most I've seen is 5-6 patients per day, but I'd say there's no official rule and that we should each gauge based on when we feel able/no longer able to listen and intervene effectively. What do you think?