Empathy vs Sympathy in Psychodynamic Psychotherapy

In my last post, I discussed the role of empathy in promoting moral behavior; it set me to thinking more about empathy and, in particular, the way people often use that word interchangeably with the word sympathy when they actually describe different experiences. If you’re already clear on that difference, bear with me.

Here are two dictionary definitions from Merriam-Webster:


“the act or capacity of entering into or sharing the feelings or interests of another”


“the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts and experience of another of either the past of present without having the feelings, thoughts and experience fully communicated in an objectively explicit manner”

In my view, the distinction between empathy vs sympathy involves the difference between entering into and sharing those feelings that another person may have verbally and intentionally expressed vs intuiting something unspoken, of which the other person may sometimes be entirely unaware. I often find that clients want me to sympathize with what they’re telling me, when in fact, they need me to empathize with and help them become aware of something unconscious they’re afraid to know. …


4 thoughts on “Empathy vs Sympathy in Psychodynamic Psychotherapy

  1. I think this is a very interesting article concerning the difference between sympathy and empathy. I don’t understand however, how this little girl could be an example. Why was her concern for the bird not genuine? I think most people would react as Stephanie did. I guess I am missing something. I should go back to the last post.

    • if we had a quoted dialogue + facial expressions and additional subconscious feelings tranferred at the moment, it might be easier to see what the author wants to say.

      In his ‘previous post’
      the author said something that puts the example in a completely different light:

      “Here’s a clinical illustration. Stephanie, a 19-year-old woman came to see me for depression, recurring nightmares, substance abuse and other issues; she was deeply troubled, with many of the features characteristic of borderline personality disorder. She also cut herself with razor blades. In one early session, Stephanie was recalling an episode from elementary school when some other children found and tortured an injured bird. My client began to tear up as she told how she’d tried to stop the other kids, pleaded with them to spare the poor bird, to no avail. “How can people be so cruel and hateful?” she cried, weeping tears that felt inauthentic to me — what we usually refer to as “crocodile tears.” I don’t mean to suggest she was consciously faking pity and sadness; while I found her depiction of the good-her-versus-cruel-them emotionally unpersuasive, she was completely taken in by it.

      Over the course of our work together, we came to understand that Stephanie struggled with powerful sadistic and masochistic impulses, violent rage and murderous feelings that led to explosive attacks on other people, a characteristic of borderline functioning. Her attempt to be “good” involved splitting off and projecting all that hostility, locating it outside in other people and then defining herself as its opposite … at least until the defence failed and all those disowned feelings overwhelmed her.”

      … which makes his example completely different.

  2. Yes I went back and read the previous post. I do understand having intuition. I hadn’t read yet about the signs seen by the fake tears and how her feelings seemed to show that in reality deep inside her was the desire to be violent and so on. I do however believe that there are people who desire to be genuinely good. I know that a part of this is self serving. But I feel that you are putting so much emphasis on the negative feelings and ulterior motives of people to make those that have no motive other than simple sympathy feel that you would undermine that. Of course I believe that good comes from within. I believe that no one is completely good. But however I don’t think that believing in God is an outside force. I believe God is within us and by creating us has caused us to have a certain amount of moral fiber. I believe that in most cases it is the outside forces that destroy those good and moral instincts within us.

    • I also feel that our natural state is to be ‘good’, but i don’t know whether this is true. I consider myself something in between a spiritual agnostic and an agnostic theist. (http://en.wikipedia.org/wiki/Agnosticism#Types_of_agnosticism) That moral, or being good comes from within, but the question always remains ‘what is being good, here and now,for that person in front of me’. Because even if all people are innately good, how many encrustations will black out this ultimate divine being?
      When you say “I believe that in most cases it is the outside forces that destroy those good and moral instincts within us”, i can only agree.

      “… emphasis on the negative feelings and ulterior motives of people to make those that have no motive other than simple sympathy feel that you would undermine that. ” … i copy/pasted and referenced from an article that is not mine, but i feel that it strongly agrees to things that keep me busy at this very moment. The blog is about psychotherapy … and of course a psychotherapist doesn’t see many people without any problems in his daily practise.

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