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Empathy is a possibility skill that is critical for social progress and human interactions. It is a nuanced, multifaceted construct that simultaneously refers to a trait and a state, a response, and a process (Cuff et al. 2016). Although defining empathy represents a research topic per se, a common operationalization refers to it as the capacity to place oneself in another’s position and understand or feel what that person is experiencing. After an overview of the historical roots of the empathy construct, this entry highlights (1) the dimensions of empathy, (2) the development of empathy, (3) protective and risks factors of empathy development, (4) the measurement of empathy, and (5) methods of prevention and intervention on empathy, with a focus on how encouraging empathy could represent an avenue of transformative change.
KeywordsAffective and cognitive empathy Theory of mind Emotion regulation Social behavior Social competences Assessment and training of empathy
A unified definition of empathy has not been utilized consistently throughout the psychological literature to date. A range of definitions have been proposed, reflecting fundamental variations in conceptualization and operationalization of the construct. For instance, empathy was defined as “the reactions of one individual to the observed experiences of another” (Davis 1983, p. 113), the “understanding of, and identification with, the thoughts, feelings, and motives of another individual” (Hogan 1969, p. 309), or “the process whereby one person tries to understand accurately the subjectivity of another person, without prejudice” (Wispé 1986, p. 320). In a contemporary review, Cuff, Brown, Taylor, and Howat (2016) identified 43 discrete definitions and outlined themes that contrast these conceptualization most saliently, including the dimensions of empathy, its nature as trait or state, or as an automatic versus controlled process. Accordingly, Cuff and colleagues (2016) propose that:
Empathy is an emotional response (affective), dependent upon the interaction between trait capacities and state influences. Empathic processes are automatically elicited but are also shaped by top-down control processes. The resulting emotion is similar to one’s perception (directly experienced or imagined) and understanding (cognitive empathy) of the stimulus emotion, with recognition that the source of the emotion is not one’s own. (Cuff et al. 2016, p. 150)
After an overview of the historical roots of the empathy construct, this entry highlights (1) the dimensions of empathy, (2) the development of empathy, (3) protective and risks factors of empathy development, (4) the measurement of empathy, and (5) methods of intervention on empathy, which beyond “treating” an empathy deficit could cultivate the possible by augmenting our understating of the world and each other.
Empathy as a Psychological Construct: Origins and Salient Dimensions
The roots of the term empathy trace back to the ancient Greek empatheia (“in passion”), but its use in the psychological literature is rather recent. It initially appears in the early twentieth century (e.g., Lipps 1903; Titchener 1909), upon an adaptation of the German term Einfühlung (“feeling into”) in the fields of Aesthetics and the Arts and coined by Vischer (1873) – a German Art Historian and Philosopher – describing the perception of the subjective qualities in an object, specifically through the projection of the self onto the object. Despite these early uses of the term, Wispé (1986) notes that until the 1980s, the terms empathy, sympathy, or compassion are used interchangeably in the psychological jargon and they have only progressively differentiated from each other since then. One exception was the Rogerian use of the term empathy that emphasized the need for the therapist to try to “live the attitudes of the other” (Rogers 1951, p. 29). While definitionally still challenging to parse out from sympathy and related constructs, a contemporary review of the term (Cuff et al. 2016) identified eight salient themes relating to the nature of empathy across distinct definitions, according to whether (1) they explicitly refer to a distinction of empathy with other related constructs (e.g., sympathy), (2) the components of empathy referred to (e.g., cognitive or affective), (3) the notion of congruency or (incongruency) of emotions elicited in the observer, (4) the impact of external stimuli (e.g., does emotional state of another needs to be explicitly observed or can it be evoked by mere imagination), (5) the distinction between the self and other’s emotional awareness (much empathy research has overlooked that the individual has to recognize that the perceived emotions are separate from the self), (6) its nature as a trait or as a state (i.e., empathy as trait is viewed as a stable capacity, whereas state empathy is viewed as an ability influenced by situational factors), (7) empathy requires a behavioral response rather than recognition, and (8) empathy is an automatic experience or one that is subject to intentional control.
Despite these numerous facets of the construct of empathy identified by Cuff et al. (2016), one of the most common way to operationalize it focuses essentially on the dimensions of empathy and mainly distinguishes cognitive and affective empathy, also coined “dual system” (e.g., Shamay-Tsoory et al. 2009). Cognitive empathy comprises of a variety of cognitive processes, all of which contribute to the ability to understand another’s mental state and/or take another’s perspective (for review and neurological underpinning, see Decety and Jackson 2004), that is, perspective taking (“the ability to construct a working model of the emotional states of others” (Reniers et al. 2011, p. 85). In contrast, affective empathy (or emotional empathy) refers to the capacity of being affected by other’s emotional state (that is, emotion contagion) and respond with appropriate emotions to those states (Shamay-Tsoory et al. 2009).
The Development of Empathy: Models and Correlates
An influential developmental theory of empathy is Hoffman (2000)’s model of empathy and moral development. According to this model, the development of empathy progresses in five stages. The first stage corresponds to “newborn reactive cry” which develops until 6 months. At this stage, when the newborn hears another baby crying, he reacts by crying. This reaction is not a simple vocal mimicry but denotes a real affective component. During the second stage called “egocentric empathic distress” which lasts until the end of the first year of life, the infant responds to other’s distress with expressions such as making a sad face or crying, and he may feel distressed himself. However, he attempts to reduce his own distress with behaviors such as taking his security blanket or seeking comfort from his parents. At the beginning of the second year, comes the “quasi-egocentric empathic distress” stage. The toddler understands that the other is in distress, he feels it, and may attempt to comfort or help the target by displaying behaviors that may typically be useful to overcome his own distress, but that may not be adapted to address the target’s distress (e.g., the toddler gives his security blanket to another child). The fourth stage, “veridical empathic distress,” develops from the end of the second year, when the toddler understands what people feel and that his internal state is distinct from others’ internal state. He is also able to take the perspective of others. Accordingly, he can adapt his behavior to the perceived needs of the distressed target. The last stage is coined “empathic distress beyond the situation.” Between age 5 and 8 years old, children can understand that people feel emotions in general contexts of life and not only in the immediate situation. They can empathize in reaction to sad life conditions (e.g., feeling sad for homeless people). Over time, as children’ understanding of emotions becomes more complex, they can empathize and better react in response to others’ distress. This developmental model is focused on empathy toward distress, because Hoffman (2000) conceptualized it in a progression of moral judgment in which negative emotions are particularly considered. However, empathy could also address positive emotions, such as happiness (Sallquist et al. 2009).
Several studies have investigated the role of empathy in children’s emotional and social development. Empathic skills favor prosocial behavior from early age (Zahn-Waxler et al. 1992a) and cooperation with peers at preschool age (Jolliffe and Farrington 2006b; Zahn-Waxler et al. 1992a). Empathy is also positively linked with emotion regulation (Lucas-Molina et al. 2018) and higher-level of moral reasoning (Eisenberg et al. 1991). In adolescence, better affective empathy skills lead to constructive problem solving in conflict contexts (de Wied et al. 2007), whereas better cognitive empathy skills help to improve friendship quality (Chakrabarti et al. 2006). Conversely, poor empathic skills were identified as risk factors for proactive aggression in school-aged children (Deschamps et al. 2018) and adolescents (LeSure-Lester 2000).
Other studies reported that empathy and Theory of Mind (ToM), defined as the understanding of own and other’s mental states (Flavell 1999), are positively linked (e.g., Wang and Wang 2016; Eisenberg et al. 2006), as they develop simultaneously and recruit common brain regions (Decety 2010; Dvash and Shamay-Tsoory 2014). However, there are some controversies as to whether empathy, especially cognitive empathy, and ToM correspond to the same (e.g., Blair 2005) or distinct constructs (e.g., Wang and Wang 2016). When considering the latter, it remains unclear which construct is antecedent to the other. In fact, it is likely that the nature of this relationship is bidirectional. For instance, in studies focused on the adolescent years, it was both observed that empathy predicts ToM and that ToM predicts empathy (Aliakbari et al. 2013). However, as these studies are cross-sectional, no inferences on causal link and directionality can be made, and more studies are needed to decipher the nature of the relationship between these constructs. Moreover, the relation between empathy and specific mental state related to ToM, such as thought and desire, should be investigated.
Protective and Risk Factors in Empathy Development
In order to identify factors that could be the best targets for intervention, it is essential to examine the factors that contribute to empathy’s “natural” development. Further, in contrast to stable factors on which it is challenging to act, there are some more state-like and malleable factors that are more prone to intervention. In typically developing children, stable individual factors include genetic factors (Warrier et al. 2018), gender (Zahn-Waxler et al. 1992b), or temperament. Among more malleable factors, language is a predictive factor of empathy (Rhee et al. 2013) on which interventions can be useful. Family factors, which are the most studied factors, include attachment relationship (Futh et al. 2008; Kestenbaum et al. 1989; Stern and Cassidy 2018), emotional expressiveness of parents (Zhou et al. 2002), parental strategies of emotions socialization (Taylor et al. 2013), in particular conversations about emotions with the child (Brown and Dunn 1991; Dunn et al. 1987), educational style (Miller et al. 1989), and the child’s relationship with siblings (Brown and Dunn 1992).
Among risk factors leading to potential deficits in empathy, there are several psychopathological diagnoses and developmental disorders, including autistic spectrum disorder (ASD), conduct disorders (CD), or intellectual disabilities. Specifically, according to the empathy imbalance theory (Smith 2006, 2009), individuals with ASD present deficit in cognitive empathy and an intact affective empathy, while the reverse is observed in individuals with CD, that is, a deficit in affective empathy and an intact cognitive empathy. Future research on non-typically developing populations could further help nuance functional and developmental processes at play in empathy and support the development of intervention guidelines.
To study empathy and better monitor the effect of empathy prevention and intervention programs, a range of measurement methods were developed, including observational methods, performance-based, or other-reported and self-reported questionnaires that may be more or less adapted to the study population of interest depending on their developmental level. For infancy and early childhood age, standardized situations are commonly set up to elicit empathic reactions. For example, the experimenter or the mother feign to hurt himself or herself (Zahn-Waxler et al. 1992a), to feel sick (Sigman et al. 1992), or to receive a present (Sallquist et al. 2009) without prompting the child to respond. Spontaneous empathic reactions of the child (e.g., verbal or physical comfort, help, giving advice, facial, or verbal expressions demonstrating concern) are noted by using an observational coding grid to obtain an empathic score.
Empathy in preschoolers and schoolers is often assessed by performance-based measures eliciting the child responses to short stories illustrating situations designed to induce emotions, such as happiness, anger, sadness, and fear (Bensalah et al. 2016). After each story, the child has to answer questions tapping into different components of empathy such as: (a) comprehension (e.g., “What’s happened to the character?”); (b) questions about how the child is feeling (to evaluate affective empathy); and (c) questions prompting the child to explain why he feels such emotion (to evaluate cognitive empathy). The measure conceived by Bensalah et al. (2016) evaluates also prosocial behaviors (e.g., give an object, play, help, tell joke) in different situations in which the target feels positive or negative emotions, by asking the child “What would you do if you were next to the little boy/girl?”
With other-reported questionnaires, parents and/or teachers rate their perception of their children’ or adolescents’ empathy abilities in daily life. The Empathy questionnaire (EmQue, Rieffe et al. 2010), targeting infants and preschoolers (from 1 to 5 years old), gives a global score of empathy as well as scores corresponding to the first developmental levels of Hoffman’s model, namely “emotion contagion,” “attention to other’s feelings,” and “prosocial actions.” For preschoolers, the Dispositional Positive Empathy Scales (DPES; Sallquist et al. 2009) and Empathy and Theory of Mind Scales (EToMS; Wang and Wang 2016) also offer a global empathy score. Griffith Empathy Measure (GEM; Dadds et al. 2012) yields a cognitive and affective empathy score, as well as a global score, and is adapted for children from 4 to 16 years old.
Self-reported questionnaires may be completed by individuals from late childhood to adulthood and refer to their own empathic skills in daily life. The majority of these questionnaires measure distinctly affective and cognitive empathy and often yield a global empathy score (e.g., Basic Empathy Scale; Jolliffe and Farrington 2006a). Some instruments include additional scales such as a “prosocial motivation” scale in the Empathy Questionnaire for Children and Adolescent (EmQue-CA; Overgaauw et al. 2017), or a sympathy scale in the Adolescent Measure of Empathy and Sympathy (AMES; Vossen et al. 2015). These scales, together with recent developments in empathy measures, could support new research furthering the analysis of profiles of empathy across different periods of life and help monitor progress under the effect of intervention programs more closely and distinctively.
Empathy expands the array of possibilities we are endowed with to understand other people. As illustrated above through the presentation of a developmental model of empathy (Hoffman 2000), empathy is not a static entity, and it can therefore be nurtured or trained to address empathy difficulties in children at risk to develop behavior disorders or with autism spectrum disorder. However, with an increased understanding of the underlying mechanism of change used by empathy trainings and interventions, empathy programs could be applied more broadly as a way to cultivate this possibility skill. The same way skills like cooperation, creativity, or critical thinking have been targeted as “21st century skills” to be nurtured and developed (Trilling and Fadel 2012), schools could encourage empathy as fundamental possibility skill which contributes to augmenting our understanding of the world and of each other. Indeed, contemporary beliefs suggest that, in our modern information society, people are becoming less empathetic than previous generations (e.g., Borba 2017), in a context of technologization of human relationships, and increased mistrust and hostility (e.g., new forms of harassment and bullying). Hence, encouraging empathy beyond “treating” an empathy deficit could represent an avenue of transformative change.
Before such broader applications be considered, understanding the main features of effective empathy interventions is pivotal. Several kinds of interventions targeting children from early childhood to adolescence exist, including school-based, parenting-based, and experimental programs. Transversally, empathy trainings are more effective earlier in children development to promote social emotional competences (Malti et al. 2016).
In school-based programs, different constructs such as empathy, perspective taking, emotion understanding, and prosocial behavior are trained in classroom settings. However, none of these training programs focused only on empathy (for a review, see Malti et al. 2016). For example, Second Step (Frey et al. 2000) proposes lessons on identifying and understanding emotions in self and others, considering others’ perspective and responding emotionally to others. To promote these competences, teachers or external speakers teach children to recognize physical, facial, and verbal cues related to emotions, interpret emotional expressions, and acknowledge different perspectives and reactions in social situations (Frey et al. 2000). Different strategies and materials are used in these kinds of lessons such as reinforcement, sharing personal experience, stories, videotapes, pictures, discussion, and role-play (Bierman et al. 2010; Frey et al. 2005). Results of studies testing such programs showed improvements in empathy, social emotional skills, and prosocial behavior (Low et al. 2015) and a decrease of behaviors disorders (Malti et al. 2016).
Parenting programs are developed to support mothers and fathers’ competences, and, in turn, to promote indirectly emotion regulation, empathy, and prosocial behaviors in children (Havighurst and Harley 2007). For example, Tuning into Kids (Havighurst and Harley 2007) teaches parents to recognize children’s positive behaviors, to change their beliefs and behaviors toward emotion to create more emotional connection with their children, and to stimulate children’s language and knowledge about emotion. To do this, lessons are based on emotional coaching (Gottman et al. 1996) and train parents using videotapes, role-play, personal experiences, diverse exercises, and principles of psychoeducation (Havighurst and Harley 2007).
Finally, experimental training program of empathy refer to innovative methods to improve empathy, such as a recent line of programs using Immersive Virtual Reality (IVR) technology. One of the feature of IVR is that it elicits embodiment, through which the user literally experiences the perspective of someone else (Puvirajah and Calandra 2015; Shin 2018) to the extent that the other’s body (i.e., avatar) is being experienced as being their own (Maselli and Slater 2013; Petkova and Ehrsson 2008). This experience resembles cognitive empathy (e.g., providing the experience of another’s perspective) and can therefore be encouraged through enhanced simulation programs using IVR. In this line, Herrera et al. (2018) showed that actual empathic response (here, helpful initiatives toward the homeless) was larger using an IVR perspective-taking program compared to less immersive perspective-taking conditions. Further, IVR can be used to simulate situations that trigger emotional responses (i.e., involving content scenario such as homelessness, or racial prejudice), leveraging the likelihood of an empathetic response. For instance, Shin (2018) used an immersive storytelling approach to bolster empathy and highlighted the role of high quality and relevant content to do so. Hence, by supporting both cognitive and emotional processes involved in empathy, together with other mechanisms (for a review, see Barbot and Kaufman 2020), IVR has the potential to elicit empathetic response in real life (Herrera et al. 2018) at a point that it has been touted as “ultimate empathy machine” (Milk 2015). As outlined above, using this empathy machine as a prevention rather than intervention tool represents a promising direction to cultivate the possible within self and society.
“Empathy is the binding substance of the human relationship by which people transmit their culture, their humanity” (Keefe 1976, p. 10). However, contemporary beliefs suggest that, in our modern information society, people are becoming less empathetic than the generations before them (e.g., Borba 2017). Hence, it becomes increasingly critical to understand the nature of empathy, its development, and ways to nurture it. While offering an overview of these important issues, this entry outlined a few important directions for future research in this field. They include, but are not limited to, (1) furthering the analysis of individual’s profiles of empathy (i.e., accounting for the multidimensional nature of the construct), which supposes (2) the development of age-appropriate measures that account for this dimensionality and which will also (3) help track more comprehensively the “natural” development of empathy, as well as (4) change in empathy in response to prevention and interventions programs. With respect to the latter, (5) development of IVR-based programs shows great promise for the generations to come (likely to increasingly adopt IVR technology). More broadly, (6) further longitudinal studies of (multidimensional) empathy are needed to decipher causal link and directional inferences on the relationship between the empathy facets, so that its developmental dynamic can be better understood, and strategies of prevention and interventions developed accordingly. All together, these efforts will contribute to a better understanding of empathy’s nature (e.g., solidify a unified definition), its development and nurture, as a fundamental possibility skill.
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