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.

I gave a good example in my prior post.  My tearful client Stephanie related the story of mean children on the playground at school, torturing an injured bird they had found; she wanted me to share in and sympathize with her expressed feelings of horror at their cruelty, thus validating her self-image as a “good person” in contrast to the other “bad” children.   As I said, I found those tears “emotionally unpersuasive”; I did not sympathize.

Instead, what I felt, though I didn’t fully understand it at that point, was an inkling of her unconscious rage.   I felt it in my body and face; I couldn’t articulate it even to myself, but I had a sense that Stephanie unconsciously felt something quite different from the feelings she apparently wanted me to share.  Such intuitions are the bedrock of psychotherapy from a psychodynamic perspective and not terribly scientific.  In my training, teachers and individual supervisors took this for granted, generally validating such emotional perceptions and treating them as “facts” to be considered along with the other material brought by my clients; but you’re often met with polite skepticism if you express this view to lay people, or even to other psychotherapists who practice in different modalities.

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How to Tell if You’re Projecting

While many of us can identify the process of projection in somebody else, few of us are able to see it in ourselves.  Think about it — how many times have you stopped yourself and said, “I’m just projecting; this has nothing to do with John”?

Our own projections are difficult to spot, first of all, because we don’t want to identify them as such:  the whole point of projecting is to rid ourselves of something unwanted.  While there are instances where people project their good qualities into others, ridding oneself of painful or unpleasant experiences is much more common.  I’ve discussed these issues in earlier posts about projection and the toilet function of friendship.  Today I’d like to talk about how we can become more attuned to and aware of our own projections, even when we’d rather not.

Projection is an unconscious fantasy that we are able to rid ourselves of some part of our psyche by splitting it off and putting it outside ourselves, usually into somebody else.  While the initial process occurs outside of awareness, maintaining or insisting upon the reality of that projection often occupies our conscious thoughts.  The process is usually distinguished by its focus and intensity.  I can explain this more clearly with an example, one I alluded to in my first post on projection.  Grouchiness is something most of us have experienced; I suspect my description will resonate for many of you and at the same time, give you the chance to study the process the next time you feel grouchy and see if my explanation makes sense.

So at the end of my work day, I may be feeling irritable because (I believe) members of my family are doing things I find annoying.  In my thoughts, I may begin to zero in on those irritating behaviors — say, that person’s irksome habit of constantly complaining about his or her daily stresses.  These irritations may become preoccupations; I may find myself intensely focused on those behaviors, waiting for them to recur; I may be talking to myself in repetitive ways that have the effect of intensifying my irritation, while at the same time justifying it.  My focus may be exclusively upon the other person with a corresponding lack of attention upon myself and my own body.  The underlying assumption is that the other person is causing me to feel grouchy and if only he or she would stop complaining (as usual!), I’d feel better.

I’m familiar enough with the process by now to recognize it, though without exception, I fight off that recognition every time.  I’ll hear myself thinking something like, “Yeah, but this time is different.  That really is irritating.”  With effort, I can silence such thoughts.  Silence is key, at least for me; as a fairly verbal person, I find the thought processes that support and justify the projections come in words.  Putting a stop to those words and focusing on my breathing is a crucial first step.  Then I have to shift the focus of my attention away from the other person and into my own body.

I “look” in various places:  my back and shoulders where I carry tension, around my eyes where I register fatigue and sadness, in my belly where I feel hunger and other kinds of longing.  I may notice that my back hurts; I may have the beginnings of a headache.  Often I discover that my body feels tired and a little achy.  I try to hold onto these sensations without “explaining” them in reference to someone else, a difficult and uncomfortable experience.  In the end, I may realize that my own day was stressful, that rather than feeling the depth of my own pain and stress, I’m projecting it outside into someone who complains and whom I mentally criticize.

This is a simple example of owning a projection, and one that many of you will likely be able to replicate.  It’s more difficult when we’re projecting experiences such as shame or neediness.  In those cases, our entire character structure may be organized around validating the reality of the projection.  The characteristic defenses against shame, for example, have as a common goal projecting damage or unworthiness into other people and then treating them in such a way as to insist upon the validity of the projection — by blaming or regarding them with contempt.

Finding Your Own Way:

Experiment with grouchiness and let me know what you find.  Does my description of the process hold true for you as well?

Next, think about other areas where an intense focus on or preoccupation with someone else may indicate that a projection is at work.  Do you find yourself dwelling on somebody’s else behavior or personality in an intensely critical or angry way?  You may have legitimate reasons, but you may also be projecting something into them.

Some other feelings that may indicate an underlying projection:  contempt (projection of shame), feelings of superiority (projection of neediness ), recrimination (projection of guilt) or envy (projection of an idealized fantasy).  I don’t mean to suggest that these are always signs of projections, but when joined to an especially intense preoccupation with the other person, they’re a strong indication.

Notice the polarity involved in these projections:  I don’t complain about stress and it annoys me that you do.  I feel no shame about my own damage but you’re a contemptible loser.  I’m not needy and pathetic like you because I’ve got it all!  I did nothing wrong and you’re entirely to blame.

Now if only I could stop thinking about you.

The Tenacity of Defenses

Despite the fact that clients in psychotherapy long for transformation, very few change anywhere near as much as they’d like (I discussed this in an early post), often remaining trapped in destructive patterns of behavior such as the cycle of crime and punishment; even when they understand that the repeated behaviors they engage in are harmful, even when they wish to do something different, they can’t seem to alter those behaviors enough.  To understand why this is so, it helps to know something about the nature of defenses as well as our neuro-anatomy.

Psychological defenses are lies we tell ourselves when we can’t bear the emotional truth.  Deeply entrenched defenses — the kind that form a part of our character, our personally distinct way of navigating emotions and relationships — originally came about because we had no other way to cope with pain as we were growing up.  If we’d had other psychological resources during childhood, we wouldn’t have needed to develop these strong defenses in the first place.  Once they’ve been active for years, they’re extremely difficult to change because they’re neurologically habitual.  Let me explain.

Every emotion or thought you have is a chemical/neurological event; each defense has a set of neural pathways associated with it in your brain and the more powerfully entrenched the defense, the more deeply “etched” those neural pathways.  I like to think of defenses as deep ruts in a well-traveled road.  Whenever you travel familiar upsetting terrain, you’ll tend to fall into those ruts — that is, you’ll use the same old defenses — just as a wheel will slip into an actual rut.  You might be able to lift the wheel out of that rut for a time, but unless you exercise constant vigilance, it will always fall back in.  Always.  It’s like the force of gravity, virtually inevitable.  In order to stay out of that rut, you either have to change the emotional terrain or figure out some other way to navigate it.  Even when you develop other techniques — laying down new “ruts”, so to speak — the old ones will always be a problem because they’ve been around much longer, with years of heavy traffic to dig them deeper.

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Envy and Jealousy

In his collection of essays on the Seven Deadly Sins, Joseph Epstein singles out envy as the most painful of those sins to experience, with none of the ancillary pleasures that go along with, say, lust or gluttony.  As I’ve discussed elsewhere, nobody wants to feel envious or to acknowledge feeling that way to others.  Like hatred in our culture, it remains a taboo subject.  It might be acceptable to admit you feel “jealous” that a friend has a trip planned to Europe or bought an expensive new pair of shoes; there’s a good chance you could one day go on such a trip yourself or add to your own wardrobe.   Jealousy, in this modern sense, means:  “I admire what you have and wish I could have something just like it, too.”  Jealousy is the cleaned up, socially-acceptable version of envy.

Almost nobody would say, “I’m envious that you’re better-looking than I am.”  You can’t change the way you or the other person looks.  Few people would admit, “I’m envious that you have a spouse and children while I haven’t had a relationship in years.”  To admit to such feelings acknowledges a level of hatred most personal relationships can’t tolerate.  For the truth is that envy, the green-eyed monster, wants to destroy what it cannot have.  The “solution” to envy — the way to find relief from the suffering it causes if you can’t have what you envy for yourself — is to make the envied object less worthy of that emotion, by spoiling or destroying it.  Aesop’s fable about the fox and the grapes speaks of unbearable desire but also describes a psychic mechanism (spoiling) active when envy comes into play.

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The Toilet Function of Friendship (and Other Relationships)

Do you have any friends who “unload” or “dump” on you, who dominate phone calls or monopolize dinners together by talking about their problems forever and showing no interest in you?  Do you dread these encounters because you always feel “shitty” afterward?  Welcome to the toilet function of friendship.

When Freud first developed the “talking cure,” he recognized that his patients experienced emotional relief after psychoanalytic sessions during which they discussed their difficulties; what he didn’t at first understand was that many of his patients were unconsciously using those sessions as a way to evacuate their pain and unhappiness rather than to gain insight about them.  I’m not sure that he ever truly recognized this phenomenon, though he did grow more pessimistic about the possibility of psychological change over his lifetime.  Many other theorists have since described this problem; many psychotherapists have the experience of very devoted clients who come into the office overflowing with pain, who fill up the session with endless words about what’s bothering them, go away feeling relieved then come back for the next session and do the same thing all over again.

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