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Empathy: DR Sabrina Russo An Najah National University

The document discusses empathy and its role in diagnosis. Empathy is defined as intellectually identifying with another's feelings or attitudes. Some describe it as momentarily identifying with another to reduce self boundaries. Empathy skills are behaviors that demonstrate empathy and can be a clinician's most powerful tool. Barriers to discussing emotions with patients and doctors are also presented, as well as a case study demonstrating empathic conversation skills like reflection, validation, support, partnership and respect.

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Mahmmoud Fuqaha
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75 views10 pages

Empathy: DR Sabrina Russo An Najah National University

The document discusses empathy and its role in diagnosis. Empathy is defined as intellectually identifying with another's feelings or attitudes. Some describe it as momentarily identifying with another to reduce self boundaries. Empathy skills are behaviors that demonstrate empathy and can be a clinician's most powerful tool. Barriers to discussing emotions with patients and doctors are also presented, as well as a case study demonstrating empathic conversation skills like reflection, validation, support, partnership and respect.

Uploaded by

Mahmmoud Fuqaha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Empathy

Dr Sabrina Russo
An Najah National University
 Empathy can be defined as an intellectual identification
with, or vicarious experiencing of, the feelings,
thoughts, or attitudes of another.
 Some have described empathy as a momentary identification with another
person in which our human capacity to feel what
another feels erodes the boundaries of self.
 Empathy skills are behaviors
that demonstrate empathy. They may be the clinician’s
most powerful therapeutic tool.
Barriers to discussing emotions

 Doctor
 1. Takes too much time
 2. Too draining
 3. Will lose control of interview
 4. Can’t fix patient’s distress
 5. Not my job
 6. Perceived conflicts of interest
Barriers to discussing emotions

 Patient
 1. Cultural taboo about discussing emotions
 2. Preference for interpreting distress in a biomedical model
 3. Somatization disorder
 4. Desire to meet doctor’s expectations
 5. Worry about being emotionally overwhelmed
 6. Lack of language for emotions
THE ROLE OF EMPATHY IN DIAGNOSIS

 Feelings that arise in the provider during an encounter may be useful in


forming a diagnostic hypothesis about the patient

 The physician’s own feelings of frustration and powerlessness in trying to


motivate the patient are often mirrored by the patient’s sense of frustration and
powerlessness in attempting to accomplish the change in behavior.

 “Does the way I feel tell me something about the patient or something about
myself?”
Case Study
While you are on call for admissions from the emergency room for
patients without a primary care physician, a 45-year-old man is
admitted because of concern that his 2-week history of chest pain may
represent unstable angina. Although the emergency room physician
acknowledges that it’s a “soft admission,” the patient has a history of
elevated lipids, a family history of cardiac disease, and his blood
pressure in the emergency room is 180/95. The patient describes a sharp
substernal chest pain that occurs at rest, when working in the yard, and
while trying to fall asleep at night. He does not smoke or have diabetes.
On examination, he appears anxious, his blood pressure on the cardiac
floor is 160/90, and he is 5% over ideal bodyweight. The rest of his
examination, laboratory tests, electrocardiogram, and chest x-ray are
normal, except for his low-density lipoprotein cholesterol, which is 160
mg/dL.
Conversation with the patients
 Doctor: Good morning, Mr. Swenson, my name is Dr. Bergen. I’ll be taking care of you while you’re
in the hospital.
 Patient: Well,Doctor, am I having a heart attack?
 Doctor: You haven’t had a heart attack. I can tell from your blood tests and electrocardiograms.
 Patient: Well is the pain coming from my heart?
 Doctor: I don’t think so.
 Patient: But you’re not sure?
 Doctor: Nothing in medicine is certain, but your age, the character of your pains, and the fact that
antacids help somewhat reassure me that the problem is most likely acid indigestion or muscular
pain.
 Patient: Don’t you think we should do more tests to be sure?
 Doctor: Although you are at low risk for having coronary artery disease, I think it would be prudent
to do an exercise stress test as an outpatient just to be sure.
 Patient: What if I have a heart attack in the meantime? I’m still worried.
 Doctor: You don’t need to be. Besides, you were admitted under “observation status” to make sure
you didn’t have an unstable cardiac condition, and we have done that. By standard protocols, you
fall into the low risk category. Don’t worry, you’ll be all right.
 Patient:Well, okay, if you say so.
Conversation using Empathy
 Doctor: Good morning, Mr. Swenson, my name is Dr. Bergen. I’ll be taking care of you while you’re in the
hospital.
 Patient:Well,Doctor, am I having a heart attack?
 Doctor: You’re understandably worried. (validation) I can tell from your lab tests and electrocardiogram that
you haven’t had a heart attack.
 Patient: Then why do I have this pain?
 Doctor: Our tests don’t seem to have reassured you very much. (reflection)
 Patient: Wouldn’t you still be worried if you thought you were working up to a heart attack?
 Doctor: I certainly would be. So you’re worried you’re going to have a heart attack. (reflection)
 Patient: That’s what happened to my father. He was raking leaves and just keeled over. I’m the one who
found him.
 Doctor: That must have been horrible. (support)
 Patient: You can’t imagine how awful it was. Every time I think of it I get upset. Sometimes it even brings on
this chest pain. I’ve been thinking about him more and more lately, especially when I go to sleep at night. It
makes me afraid to fall asleep. I’m afraid I’m not going to wake up.
 Doctor: Is there a reason why you’ve been thinking about him more lately?
 Patient: Yeah.I thought I got over his death. But this is the time of year he died. Just raking leaves, which I
do every weekend, makes me think of him. Then I get this chest pain and worry about myself. Heart disease
runs in families, I don’t have to tell you.
Conversation using Empathy
 Doctor: I’m sorry about your father (support). It sounds as though there’s a pretty strong connection
between thinking about your father and the chest pain.
 Patient: Yeah. I thought maybe being upset stressed my heart. Do you think maybe this is all in my head?
 Doctor: I’m sure you really feel the pain, and I suspect your heart still aches for your father—even if only
figuratively. It’s pretty hard to lose a father. Now, you know there’s a pretty strong connection between the
body and the mind, and if you’ve been worrying about your own health, this could be your way of making
sure you take care of yourself.(respect)
 Patient: I never thought of it that way. What you say makes a lot of sense, and I think you’re probably
right. But I still have this nagging worry in the back of my mind.
 Doctor: That’s understandable. (validation) How about this? Let’s work together to reduce whatever risk
factors you do have for heart disease to make sure you don’t have a problem down the line. (partnership)
Although you are at low risk for having coronary artery disease, I think it would be prudent to do an
exercise stress test as an outpatient just to be sure. I’m going to give you my card so that you can call my
office to set it up when you get home. Any time in the next few weeks would be fine. Andin the meantime,
if the pain gets worse or change in any way, give me a call. Right now you’re having some pretty strong
feelings about your father, and if that is the source of your chest pain, it may not go away right away. We’ll
talk more about it when I see you in the office.
 Patient: That seems reasonable to me. I appreciate your listening to me.
 Doctor: Okay, then, I’ll see you in a few weeks. And remember, if the pains get worse or you get new
symptoms along with them, call me immediately; don’t wait till the next day.
 Patient: Thanks, Doc. See you in a few weeks.
The empathic skills.

 Skill Example
 Reflection “You seem upset.”
 Validation “I can understand your anger with the way you were treated.”
 Support “You are doing very well handling your grief.”
 Partnership “Perhaps we can work together to make you feel better.”
 Respect “You have tremendous compassion for your siblings.”

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