DTD150
[00:00:00] This is the DriveTime Debrief, episode 150.
Amanda: Hey guys, welcome back to the podcast. I’m Amanda.
Laura: I’m Laura.
Kendra: And I’m Kendra. Today, I’m going to let Kendra introduce our topic.
Kendra: Hey guys, welcome back to the show! Today we’re going to explore emotional intelligence, self-awareness, and how we can all lead richer, more [00:01:00] connected lives. Not that we don’t aim for that every podcast, but today we’re diving into a chapter from Brené Brown’s Atlas of the Heart—our favorite—on sympathy versus empathy.
This episode, we’re going to examine the difference between sympathy and empathy using insights from the chapter. Then, in part two, we’ll apply those ideas with some “empathy misses” and examples, including how I’ve definitely missed the mark on empathy in a few patient cases—something I know I could improve on.
First, we want to define sympathy and empathy because these terms are often used interchangeably but are actually very different. In Atlas of the Heart, this topic is covered in Chapter Seven: “Places We Go With Others.” This chapter is very others-focused.
And so, in this chapter, Brené Brown also discusses compassion, pity, boundaries, and comparative suffering. You can see how all of these have an “other” focus, but they’re all very, very different.
Sympathy is feeling pity or sorrow for someone else’s misfortune. It’s a perspective where you feel for someone but remain removed. At arm’s length, you’re like, “Oh gosh, that sucks for you,” or “I feel bad for you.” You might acknowledge their pain, but you don’t necessarily engage with it. Sympathy can sometimes feel protective because, if you acknowledge that you’ve had a similar situation, you might not want to be vulnerable in that moment or relive those feelings. So, sympathy keeps you at a distance. It can feel like pity, and we’ll talk more about how it’s actually a disconnect rather than a way to connect.
Empathy, on the other hand, involves stepping into another person’s emotional experience. It’s about connecting with their feelings and responding in a way that makes them feel heard and understood.
We were actually talking about this before going on air—you should check out Brené Brown’s little cartoon video on sympathy and empathy. It’s really cute! She uses the visual of getting down into the hole with someone, sitting with them—not necessarily trying to fix anything or give advice—but just saying, “Hey, this is uncomfortable, but I’m here for it.”
And I’m going to sit with it, and I’ll be here for you. Brené Brown points out in her book that when we feel sympathy for someone, we may want to help, but their pain remains distant. We see the person suffering, but we don’t always know what to do with it. With empathy, we don’t just see the pain—we actually feel it with them. And that is how we connect. That’s the connecting feeling.
Empathy, however, comes with a bit of risk. After spending many years studying human connection, vulnerability, and courage, Brené Brown found that empathy requires emotional vulnerability, as we mentioned earlier. It’s not easy to be fully present with someone in their pain, especially if it triggers our own emotions [00:04:00] or leaves us feeling helpless.
For example, if someone is experiencing something you’ve never gone through, you might feel completely helpless—wondering, “What can I even say in this moment? What can I even offer?” This uncertainty can lead us to resist trying altogether. We might avoid engaging out of fear of saying the wrong thing, coming off as insensitive, or simply screwing it up.
But empathy isn’t about fixing someone’s problems or offering solutions. It’s about being fully present with them in their state. Most of the time, that state is uncomfortable—usually pain, usually suffering. To truly be present in those moments is tough.
Brené Brown elaborates: empathy is a choice, and it's a vulnerable one. It's not something we do because we're trying to make the person feel better, but because we're trying to connect with them in their pain. And, like we said, it's very, very risky because it may trigger something in you to feel that type of pain. You may not have had the same experience, but it may just trigger [00:05:00] or bring up all those feelings that you had with a similar experience or something that invoked similar feelings.
I think it's really interesting—there have been a few studies on med students and their emotional intelligence over training and then after training. Empathy is one of the markers of emotional intelligence, and their empathy goes down. And, like, I think we can all see this amongst our, you know, our classmates and our residency classmates and our colleagues—empathy going down.
But, like, as you're describing what it means to have empathy, it's not surprising that we don't exercise empathy all day, every day, because we do encounter so much suffering. And it would probably be overwhelming if we were fully present with every one of our patients and all the suffering that they're experiencing.
I don't know—like, not to say that we can't be more [00:06:00] empathetic, but it is emotionally risky. And wow, what would it be like to take on the full—well, we already know we take on some of the experience of our patients, but to take the full amount on for each one?
Would be—I don’t know. I don’t think it would be sustainable.
No, for sure. And that’s what would be my only issue with this chapter in the book—it makes it sound like sympathy is bad versus empathy is good. I don’t think that’s what she’s trying to say. It’s definitely better than neutrality about something or even schadenfreude (I don’t know if I’m saying that right)—like, delight in the suffering of others. It’s just not the same.
So, while sympathy can sometimes create disconnection (we’ll talk about that), empathy fosters connection. And if connection is your intention, that’s where you need to be—with empathy—because sympathy can sometimes create a sense of distance.
Now, I’m telling you, in the ER, sometimes we have to rely on sympathy, or we’d be crying all the time. I noticed a big difference after I had kids with pediatric codes. It really weighed [00:07:00] on me after I had my own kids because I was experiencing it as the mom, you know? And that’s too much after a while.
Right. So, it makes sense, but just know for yourself that sympathy can sometimes create a sense of distance. Brown’s research highlights how sympathy can create a power imbalance where the person offering sympathy feels more superior or removed from the person they’re attempting to comfort.
And you can imagine—when someone is always offering you help, but they never ask for help back—you can see how that might unintentionally set things up as, “Oh, yeah, you’re the one—you’re the mess that always needs help.” You know what I mean?
Like, nobody’s saying that, but you could see how somebody might feel that way.
Yeah. And so she writes that sympathy often involves feeling sorry for someone from a distance. While the intention may be good, it often feels dismissive or condescending, and this can result in the person receiving sympathy feeling even more isolated—as if their [00:08:00] experience is something to be pitied or avoided.
And honestly, feeling pitied is like a trigger. I’m not good with that.
Yeah, she talks about that also in the chapter. She elaborates on cancer patients being on the receiving end of sympathy. They almost felt it was unwanted, like it came across as a pity-based response. And although most of the people offering it were well-intentioned, the person receiving the sympathy felt like it was very focused on my discomfort as the cancer patient and not really about alleviating my distress.
So it was just further labeling how terrible my cancer or this diagnosis is, my discomfort about going through treatment and having cancer, and less about actually trying to alleviate it—or even just sitting with me in it. That was a good perspective to see.
My ER humor is kicking in with the meme where it’s the guy with the broomstick patting the girl hugging the toilet on the back. Like, “There, there,” but he’s on the other end of the broom, keeping his distance.
Sympathy is definitely better than delighting in somebody’s demise or being neutral, but you can see how it’s different from empathy and doesn’t create the same sense of connection. It might make sense for us in our medical practices, but just having that awareness is, I think, the intention of this podcast—before we go over the misses and the follow-up piece.
So, she describes sympathy as something that, rather than bringing people together, can reinforce the idea that the person in pain is other, is separate from you. It creates a sense of alienation, in a way, unintentionally.
Yeah, I can see that. So, how do we cultivate empathy? Can we build our empathy muscles? According to Brown, the first step is recognizing and naming our emotions.
That is the intention of so many of these [00:10:00] podcasts: to give us that emotional granularity, or the ability to recognize and name exactly what it is—the emotion that we’re having. She explains that in order to empathize with others, we must be in tune with our own emotional states.
Oh, and if you remember from many of these podcasts, most people can only name three of their emotions correctly. A lot of doctors are all up in their heads and completely detach from the emotional part of their bodies. We don’t drop into our bodies and feel things.
So, it’s a practice to start doing. When we don’t know how to identify or process our own feelings, it becomes much harder to connect with other people’s emotions.
That makes sense.
Next, Brown suggests listening without judgment or the urge to fix the situation. Empathy thrives in spaces where we can just be present with someone without offering advice or solutions. She encourages us to ask open-ended questions and reflect the other person’s emotions back to them. This validates their feelings and makes them feel seen.
This is the perfect cure for my frustration [00:11:00] I used to have all the time. I would feel so frustrated when the 20 times kept coming back because I thought I was supposed to do something. Like, how am I going to fix this? She’s already had every single test.
Like, what does she want me to do? This is something you can hold space for someone. You can let them have a human experience. You're not trying to fix anything, but sometimes they've never been heard. They've been dismissed over and over or, you know, even gaslit. Sometimes. So, it is therapeutic to just be with someone experiencing their humanity on planet Earth.
That made me feel much more empowered—that I was doing something.
So, Brown also emphasizes the importance of body language with empathy. Sometimes a simple touch or a steady presence can communicate more empathy than words ever could. And here’s a quote: "Empathy is about being in the moment with someone, and our bodies often convey empathy in ways that words can't."
I really had an eye-opening experience—same [00:12:00] frustration. The patients you go back in the room are like, "Great news! Everything looks negative," and they’re just like, “Well, then what's wrong with me?” And they fire back at you.
The next question that I’ve been asking more frequently is, "What are you most worried about?" Sometimes just giving them that open-ended question, like, “I see that everything being negative is not the best news you’ve ever heard. So, what are you most worried about? What is the thing that maybe you haven’t heard me say, or that the test can’t really explain, you know, work up or whatever?”
And usually, just even asking that question, I find it really kind of... allows the situation to come down about 10 notches.
Yeah, I find that empathizing in that situation is important—like, "I know this is super frustrating. I know you don’t feel good, and what we found out today is that there’s nothing that’s going to kill you in the next 24 hours."
But we've got a plan to help you find more answers, and I just hope you feel better soon. It's just [00:13:00] tough. It is tough in those situations. And I’ll also say it’s tough as doctors sometimes, at least in my experience, to switch out of problem-solving mode and into listening and empathy mode—especially with people who are close to you. We’re used to people coming to us for advice or coming to us to fix problems.
I certainly have the urge to, when I can clearly see what could fix a loved one’s problem. It’s really, really hard for me not to jump in with that or to ask permission, you know, like, "Hey, I can offer empathy. This is really hard, I can see that. And if you want any thoughts that I have on it, let me know. I have some that I can share later."
But it’s tough to just be like, "Oh, well, if you just do this, it’s going to be fine," you know? But, that’s not empathy.
So, she talks about the power of empathy and building connection. She’s done a bunch of research on this, and it shows that empathy is the foundation of deep [00:14:00] human connection.
By embracing empathy, we’re more likely to build trust, create stronger bonds, and foster environments of mutual understanding. And really, at the heart of this is creating a space where someone can feel safe with you, and you can feel safe with them. Where your feelings are not wrong, or dismissed, or something that needs to be fixed, but you can be you, and they can be them, and you can be in the same space together—as she notes in Atlas of the Heart.
This is a quote: "When we practice empathy, we allow people to be seen and heard, not as they should be, but as they are." And I would add, accepted as they are. This is a powerful way of creating emotional safety for those around us. It opens the door for people to be authentic, to share their struggles, and to feel accepted for who they truly are.
Another psychologist that I follow, Jennifer Finlayson Fife, talks about this as... these really intimate human [00:15:00] relationships where we are willing to know someone else as they are, and to be known as we are. And empathy really is like the fertile ground for that.
So, how do we practice empathy? It's not something that just happens. It’s definitely something that we have to cultivate and a lot of times override our own natural instincts, like instincts to provide advice or instincts to correct, or instincts to even dismiss. Like a lot of times, this has been our experience. Anybody who is an adult right now probably had this experience growing up, where you had feelings and your parents...
Or someone you loved told you, "Oh, it's not that bad. Oh, you'll get over it. Oh, you know..." Totally dismissing these emotional experiences that we've had. And it’s from a good place. I’ve done it myself to my kids before, and I probably still do it now, but I definitely try not [00:16:00] to. When they’re like, "I’m just worried about this," and I say, "Oh, it’ll be fine. It’s all going to work out," thinking that I’m encouraging them, when really, the best first step for connection would be to acknowledge what they’re experiencing and experience it with them. I’d say more like, "I can totally see why you’d feel that way. That makes complete sense."
Yeah, when I do that, I notice I’m so uncomfortable with my child being uncomfortable. Yes. So really, I need to manage my own emotions. Because, unfortunately, when we tell our kids things, they only learn by us doing—by being an example. So what I need to do in that situation is get myself under control so that I can hold space for my child. But I’m so uncomfortable. I want him to be happy all the time. It’s just not me.
When we feel discomfort, it really is usually our growth happening. Yes. So, sympathy is going to feel safer because it doesn’t require us to have the shared [00:17:00] experience, but it’s going to fall short in creating that genuine connection that we want. And empathy... we’re more vulnerable, but it is the key to deeper, more meaningful relationships.
And Brené has done so much incredible work, and her work on empathy shows us that it’s not just about connecting with others, but also about embracing our own vulnerability. Like as the parent, I want to make everything perfect for my kid, but the reality is I can’t.
And when I am going to them, denying their experience and saying, "Oh, it’s going to be okay," that’s me trying to make myself feel better. Like I’m going to be able to make it be okay. No. It’s okay. They’re going to have their own discomfort, just like I have my discomfort, and it all is going to promote growth, hopefully.
It’s about recognizing we don’t have all the answers, although, as doctors, we like to think we do a lot of the time. And sometimes the best thing we can do is just simply be [00:18:00] present with someone in their pain and not try to fix it or even say anything. Just be there and accept the experience that they’re having as we move forward.
Create that safe space for them.
Yeah. And one thing I want to add is, at the end of the chapter or this part on sympathy and empathy, she talks about compassion fatigue. We hear that a lot because of the line of work that we’re in. It’s usually referred to hand in hand with emotional exhaustion, burnout, you know, all the buzzwords. But what she says is the term that we use is kind of almost incorrect because compassion fatigue also can occur when caregivers focus on their own personal distress rather than on the experience of the person they’re caring for. So, focusing on one’s own emotional reaction results in an actual inability to respond empathetically to the person in need.
In this view, the more appropriate term, rather than compassion fatigue, might be empathetic [00:19:00] distress fatigue. So, we’re not hearing the story; we’re inserting ourselves into the story. And so that’s why it can kind of sound exhausting. Well, it is exhausting, like we talked about. If we were empathic with every patient that we saw, if we see 18 to 20 patients a shift, like I think about that and I get exhausted just thinking about it. But it doesn’t have to be that we actually insert ourselves into the story of our patient. There is a way that we can connect, like we said, with a touch on the hand, holding space. Not rushing in, rushing out—maybe just lingering for a couple of seconds, just to make sure that there’s nothing else you want to say about this or whatever. There is a way to kind of be protective of yourself so that you don’t get to that compassion fatigue, but you still strive to be or form that empathic connection.
Yeah. One way I do that is, as soon as I walk in the door—because lately, wait times are horrible—I just say, "I am so sorry. I know it's been super frustrating to wait so long, and I know you don't want to be here and you don't feel good. I'm sorry about all of that. Tell me what's going on."
And that doesn't require taking on any more deep knowledge that I can take home and ruminate on. I mean, I definitely do take on stuff from probably three or four patients a shift, but I don't have to take it on for all of them.
Yeah, that's good. And then the final quote I love when she says, "We need to dispel the myth that empathy is walking in someone else's shoes. Rather than walking in your shoes, I need to learn how to listen to the story you tell about what it's like in your shoes and believe you, even when it doesn't match my experience."
I love that. Yikes. So, yeah, we’ll leave you with that one. Thanks for tuning in today. We're so glad that you signed up to listen to our podcast. Follow us on the socials, all the goodness. We’ll always remind you to leave us a review and five out of five stars because it makes our ripple that much bigger.
And if you have any experiences, if this struck a chord, or if you want to know more about empathy, just shoot us a quick email at [email protected]. We'd love to hear about it.
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So until next time, you are whole, you are a gift to medicine, and the work you do matters.
