Improving Empathy in the Care of Pain Patients

Philip L. Jackson, Fanny Eugène, Marie-Pier B. Tremblay
2015 AJOB Neuroscience  
Empathy is associated with countless benefits in clinical interactions, yet it is not always optimal in health care providers. Social neuroscience offers a window onto the cerebral processes underlying the complex relationships between the multiple components of empathy, patient care, and the caregiver's well-being. Neuroimaging studies have revealed patterns of empathyrelated neural responses that shed some light on the mechanisms that could partially explain the phenomena of empathy decline
more » ... d pain underestimation in health care providers. Such information, complementary to behavioral research findings, may help develop new means of improving empathy in health care, as long as interpretation of neuroimaging data remains grounded. Additionally, research on empathy in this context has largely focused on how clinicians' empathy may affect patient outcomes, but the relationship between empathy and well-being in health care providers is often neglected. The quest to optimize empathy in patient-clinician interactions must take into account the welfare of both members of this dyad. Health care providers, who share the noble calling of helping others in need, are frequently exposed to pain and emotional suffering, and often on a daily basis. How they respond to this suffering can have a significant impact on their patients, as well as their own well-being. One very important aspect of patient-caregiver interactions that has received substantial attention over the last decades is clinicians' empathy. Empathy in this context, typically assessed through self-reported measures, has been associated with more accurate diagnoses, as well as reduced distress and increased satisfaction and compliance with treatment in patients (Neumann et al. 2011) . While self-reported measures offer valuable information on dispositional empathic abilities (i.e., a person's traits or general tendencies, rather than actual behavior), most do not allow the examination of how empathic responses may vary depending on the patient or the context, which is important given the multiple factors that can affect clinicians' empathy. By measuring the neural correlates of empathy in different experimental contexts, social neuroscience research has provided a complementary and perhaps more objective (albeit not absolute, as discussed later) perspective on clinical empathy. In this review, we wish to provide a comprehensive summary of what we have learned from social neuroscience research about 3 3 empathy in the context of patient care. Our article also highlights the potential benefits of promoting empathy from both the patient's and the clinician's perspective, and examines the ethical implications of using state-of-the-art neuroscience methods to shed some light on this multifaceted, and mostly covert, mental process. UNIFYING EMPATHY One of the challenges in empathy research is the variability in how this concept is defined and measured across studies. Empathy is generally defined as an ability to perceive, understand, and, to varied extent, share the emotional state of other individuals. Neurocognitive and multicomponent definitions (e.g., Decety and Jackson 2004), which imply that empathy deficits can stem from changes in distinct yet interacting components, are well suited for empirical testing of this complex construct. Two components are found in most definitions of empathy: A first component, called resonance, refers to the automatic sharing of other people's affective and sensorimotor experiences; a second component, often referred to as perspective taking (and akin to mentalizing and theory of mind), implies a more controlled and deliberate understanding of what others are feeling and thinking. Three other components
doi:10.1080/21507740.2015.1047053 fatcat:a2uxbfnbkfh57i32f7no6ulhjy