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PubMed1995

Empathic responsiveness and affective reactivity to infant stimuli in high- and low-risk for physical child abuse mothers.

Empathic responsiveness and affective reactivity to infant stimuli were examined in matched groups of high- and low-risk for physical child abuse mothers. Hypotheses were generated based on models of aggression and the child abuse literature. Although no between-group differences were found in empathy, within-group differences were observed. Compared to baseline, high-risk mothers reported no change (p > .05) in empathy across infant conditions (baseline, smiling, quiet, and crying), while low-risk mothers reported an increase (p < .0005) in empathy following presentation of the crying infant. Although there was no change in empathy, high-risk mothers reported more sadness, distress, hostility, unhappiness, and less quietness following presentation of the crying infant. Low-risk mothers reported no changes in sadness, distress, and hostility. The data for high-risk mothers are congruent with reports that physical child abusers are less empathic and more hostile in response to a crying child. The findings support aggression models which suggest the lack of empathy and the presence of negative affectivity precede abusive behavior. Post-hoc analyses also provide support for an emotional contagion perspective, where high-risk parents, compared to low-risk parents, are thought to more frequently reflect the emotional state of the infant.

Adult↗
PubMed1976

Fantasy and self-esteem of renal dialysis patients and their spouses.

The fantasy life and self-esteem of 22 male and 13 female renal dialysis patients and their spouses were examined using a Self-Esteem Evaluation Scale, Empathic Fantasy Scale, and eight portions of the Imaginal Process Inventory reflecting eight types of fantasy use. For the patient group as a whole, a high degree of fantasy behavior was associated with low self-esteem, but the sex of the patient made a difference. Frequency of fantasy was shown to be indicative of poor adjustment for female dialysis patients, but not for male dialysis patients. Results also indicated that patients, without regard to sex, were more prone toward guilt fantasies in which they were punished for some wrongdoing such as feelings of anger toward people involved in their treatment or envy of others who do not suffer their same disability.

Adaptation, Psychological↗
PubMed2002

Teaching communication skills: a skills-based approach.

OBJECTIVES: The purpose of this project was to design structured training activities to emphasize key points about patient-physician communication. Effective communication has been shown to enhance patient satisfaction, compliance with treatment, and medical decisions and outcomes. Basic communication skills and behavioral-change interview skills are taught. DESCRIPTION: Communication is a core "building block" of a four-semester, two-year Essentials of Clinical Medicine Course (ECM), which is in its second year of existence. Four interactive lab sessions have been designed, each with structured learning exercises. At the beginning of each session, students work in groups of 30 completing activities based on videos developed by the Bayer Institute for HealthCare Communication.(1) Subsequently, two groups of three students each work with a behavioral or physician facilitator. A formal training and administration manual for all activities has been developed and an evaluation system developed and implemented. Session 1, "Initial Interview Skills," teaches opening, mirroring, and encouraging non-interrogation activities. Session 2, "Empathic Responses," includes activities entitled "Cue Detection," "Accurate Empathy," and "Getting the Story Straight." In Session 3, "Obtaining an HPI," students view an exemplary medical interview, then role-play computerized cases(2) and practice the HPI data collection based on clinical facts taken from the computerized cases. During the Session 4, "Putting It All Together," students interview a standardized patient (SP) for five to seven minutes and receive and give feedback from peers, SPs, and facilitators. Subsequent to the communication lab, students conduct six physician-supervised patient interviews practicing their medical interviewing skills and write-ups. Two subsequent small-group sessions include "group" interviews of SPs in which students assess readiness for behavioral change (e.g., quitting smoking, losing weight) and also learn to conduct more "difficult' health-promotion conversations (e.g., sexual behavior, alcohol use). Evaluation methods include the use of a professional behavior evaluation form completed by communication facilitators and small-group leaders. This assessment form consists of ratings on: reliability and responsibility, relationships with others, self-improvement and adaptability, upholding professional standards, and communication skills dimensions. A formal interview-behavior checklist is used during the training and in the feedback sessions. Finally, SP OSCEs of communication and behavioral-change interviewing occur at the end of the first year of training. DISCUSSION: The communication labs have been well received by students. Students have reported increased understanding of their upcoming roles as physicians, have stated they have gained insights about the importance of connecting with patients in order to give them proper medical treatment, and have requested additional training in communication. Students have reported increased confidence in their interviewing skills prior to interactions with "actual" patients, and clinical preceptors have reported increased levels of preparedness among students who have participated in the structured learning experience. Future plans include adding communication training with problem patients, and about end-of-life and other challenging issues.

Communication↗
PubMed2007

[Practice of psychotherapy for cancer patients].

Cancer is a threat to life and to the psychological well-being of patients. Previous studies have demonstrated that several patients with cancer have suffered from psychological distress. Psychotherapy for cancer patients is effective against psychological distress. There are several kinds of psychotherapy for these patients, such as supportive psychotherapy, cognitive behavioral psychotherapy including relaxation techniques and cognitive restructuring, and supportive-expressive group psychotherapy. Supportive psychotherapy is feasible for many clinicians. Psychotherapists develop a trustful relationship with patients, provide an empathic posture, and use various types of psychotherapeutic treatments. It is important for psychotherapists to understand the psychological background of such patients from various viewpoints.

Humans↗
PubMed1992

Therapeutic empathy and recovery from depression in cognitive-behavioral therapy: a structural equation model.

This study demonstrated that therapeutic empathy has a moderate-to-large causal effect on recovery from depression in a group of 185 patients treated with cognitive-behavioral therapy (CBT). The authors simultaneously estimated the reciprocal effect of depression severity on therapeutic empathy and found that this effect was quite small. In addition, homework compliance had a separate effect on clinical recovery, over and above the effect of therapeutic empathy. The patients of novice therapists improved significantly less than did the patients of more experienced therapists, when controlling for therapeutic empathy and homework compliance. Ss who terminated therapy prematurely were less likely to complete the self-help assignments between sessions, rated their therapists as significantly less empathic, and improved significantly less. Ss with borderline personality disorder improved significantly less, but they rated their therapists as just as empathic and caring as other patients. The significance of these findings for psychotherapy research, treatment, and clinical training is discussed.

Adolescent↗
PubMed2005

The relation of facial affect recognition and empathy to delinquency in youth offenders.

Associations among facial affect recognition, empathy, and self-reported delin-quency were studied in a sample of 29 male youth offenders at a probation placement facility. Youth offenders were asked to recognize facial expressions of emotions from adult faces, child faces, and cartoon faces. Youth offenders also responded to a series of statements on emotional empathy, and provided self-reported acts of delinquency. Findings revealed a moderate positive relationship between ability to recognize the expression, angry, in adult faces, and self-reported acts of delinquent behavior, which included physical violence, theft, and vandalism. Findings revealed a moderate inverse relationship between ability to recognize facial expressions of emotions in child faces and self-reported acts of physical violence. With respect to specific facial expressions of emotions in child faces, a moderate inverse relationship was found between ability to recognize the expression, fearful, and self-reported acts of physical violence. A moderate positive relationship was found between ability to recognized the expression, fearful, in child faces, and ability to empathize with the emotional experiences of others. Strong and moderate links were found between the negative expressions, fearful and sad, and angry and sad, respectively. Additionally, a strong inverse relationship was found between ability to emphathize with the emotional experiences of others and self-reported acts of delinquent behavior. Lastly, a strong positive relationship was found between covert and overt self-reported acts of delinquent behavior. Results from this exploratory investigation suggest a link between facial affect recognition, empathy, and delinquency. Findings have important implications for educators and counselors who work with youth offenders within probation placement facilities.

Adolescent↗
PubMed1979

Explorations in the uses of language in psychotherapy: complex empathic statements.

I have suggested (1978) that the language occurring to us in personal and psychotherapeutic speech reflects our distance from one another, and that the empathic position in particular evokes emotional reverberations and spontaneous verbal accompaniments which serve to identify that position. I have also suggested some prototypic forms of this spontaneous empathic speech. A clinical anecdote and two observations will illustrate these points and prepare for the discussion of more complex empathic forms.

Attitude of Health Personnel↗
PubMed1989

Adolescents' compliance-resistance: effects of parents' compliance strategy and gender.

This investigation determined choice of compliance-resisting behaviors on the basis of compliance-gaining strategy, gender of parent, and gender of adolescent. One hundred and eighteen 9th- through 12th-grade students identified resistance strategies they would use when confronted with five compliance-gaining attempts: manipulation, nonnegotiation, emotional appeal, personal rejection, and empathic understanding. Each compliance-gaining attempt was associated with a specific parent and a specific compliance-gaining strategy. The results demonstrate significant differences in resistance strategy selected on the basis of parent's gender, adolescent's gender, and compliance-gaining strategy. When mothers employed personal rejection or empathic understanding, the adolescent was most likely to use nonnegotiation. When the mother used an emotional appeal, adolescents used identity management. Fathers who employed manipulation by using an emotional appeal were resisted with justification. When fathers used nonnegotiation or personal rejection, adolescents used nonnegotiation. The father's use of empathic understanding was countered with identity management. Adolescents are more likely to use identity management with their mothers and justification with their fathers. Female adolescents are more likely to use identity management than are male adolescents, while males are more likely to use nonnegotiation and negotiation than are females. Nonnegotiation occurs most often from son to mother, followed by son to father, daughter to father, and daughter to mother.

Adolescent↗
PubMed1995

The fullness of empathy: reflections and illustrations.

Seven core values are said to undergird the profession of occupational therapy, with empathy serving as a hallmark of one of those values-personal dignity. This inquiry explores the meaning of empathy within a practice that holds occupation at its center. The literature on empathy in both philosophy and the behavioral sciences yields cogent thoughts about the fullness of empathy and its characteristics actions. The Healing Heart, the biography of a pioneer therapist, Ora Ruggles, shows the manner in which occupational therapists can be empathic in their practice. These reflections and illustrations serve to sharpen the vision of occupational therapists as persons who reach for both the hands and the hearts of others.

Empathy↗
PubMed1997

Mutually responsive orientation between mothers and their young children: implications for early socialization.

Parent-child mutually responsive, binding, reciprocal orientation, or a system of reciprocity has been implicated as fundamental in socialization, particularly by Maccoby, but it remains poorly understood. In this study, two posited components of such orientation, mother-child shared cooperation with each other and mother-child shared positive affect, were measured in multiple contexts of daily interactions using a combination of micro- and macroscopic behavioral coding systems, and subsequently aggregated. Mothers' self-reports were also used. Two implications of thus conceptualized mutually responsive orientation were examined: mothers' use of power in disciplinary interactions and children's degree of internalization of maternal rules, both assessed using multiple observational and mother-reported measures. Mothers and children were studied twice, when children were 26-41 months (Time 1, N = 103), and when they were 43-56 months (Time 2, N = 99). In the dyads high on the mutually responsive orientation (particularly those who maintained such orientation throughout early childhood), mothers resorted to less power and children were more internalized regarding maternal values and rules, in the contemporaneous and longitudinal sense. Mothers high on empathic perspective taking were more likely to establish a system of reciprocity with their children. The importance of such systems for social development is discussed.

Adult↗
PubMed2004

Greater right frontal EEG asymmetry and nonemphathic behavior are observed in children prenatally exposed to cocaine.

Responses to emotion-inducing stimuli were examined in 27, 3- to 6-year-old children, who were prenatally exposed to cocaine, and 27 unexposed controls. Children were monitored for EEG activity and their affect during an infant crying, simulated maternal distress, and a mildly frustrating task. Multivariate analyses indicated that the cocaine-exposed children had greater right frontal EEG asymmetry, showed fewer empathic reactions to a crying infant as well as to their own mothers, and they were less proficient in completing a cooperative task. These findings highlight the need for continued longitudinal research on the effects of early drug exposure for later socioemotional development.

Adult↗
PubMed1984

Individual differences among adult women in sensitivity to infants: evidence in support of an empathy concept.

Emotional and physiological responsivity to infant signals was assessed in individuals who differed markedly in their level of empathy. Eighteen high-empathy and 20 low-empathy female observers viewed videotaped scenes of smiling, quiescent, and crying 5-month-olds as the observers' physiological and facial reactions were monitored. Subjects then rated their subjective emotional reactions to the scenes and judged the intensity of the infants' need for care. High-empathy subjects had larger electrodermal responses, tended to respond with matching facial expressions, had more extreme happiness and sadness reactions, and indicated stronger desire to pick up the infants. Additionally, the empathic group showed a trend toward greater cardiac responsiveness to the signals. The results support the hypothesis that high-empathy individuals are more emotionally responsive to infant emotional stimuli and hold different values about caregiving behavior. Applications of the findings to the training of caregivers are considered.

Adolescent↗
PubMed1985

Female exhibitionism.

Although genital exhibitionism has traditionally been almost exclusively associated with males, similar behavior may occur in certain women with a particular set of life circumstances and precipitants. A case report is presented of a woman whose emotional deprivation led to feelings of rejection and the inability to develop empathic relationships. Her self-esteem relied on success in her profession, and when she lost her position, she sought validation through exhibitionism. Despite the widely held view that genital exhibitionism producing arousal and stimulation in the subject occurs only in men, this case demonstrates that such phenomena may exist in women as well.

Adult↗
PubMed1988

Anorexia nervosa: psychological considerations for nutrition counseling.

This article presents the underlying psychological beliefs and self-perceptions held by individuals with anorexia nervosa. The intent of this article is to help dietitians and other nutrition counselors become more aware of the psychological characteristics of individuals with anorexia nervosa and become familiar with various counseling skills that can assist counselors when they are working toward reaching the goal of re-establishing normal eating patterns and attitudes about food. Counseling approaches that may be used by the nutrition counselor in an effort to deal effectively with the various psychological characteristics displayed by anorexics are provided. Nutrition counselors must be well informed of the psychodynamic aspects that prevail in the disorder, such as low self-esteem, frustration over gaining weight, and a distorted body image. In addition, nutrition counselors must be aware of the particular communication skills (e.g., attentive listening, empathic responses, and verbal encouragement) and basic therapeutic methods (e.g., encouraging self decision making and providing support and acceptance of thoughts, feelings, and actions) that can be used for effecting positive growth and changes in dietary behavior of individuals with anorexia.

Anorexia Nervosa↗
PubMed2004

Psychoanalytic supportive psychotherapy of a terrified communist: report of a 37-year treatment.

This is a case report of a 37-year treatment of a victim of the Holocaust. It illustrates the use of psychoanalytic based supportive psychotherapy to enable a severely damaged person to pull himself together and live a respectable life. The case is of special interest because a careful evaluation of the patient's ego functioning was important all through the treatment, and revealed an unusual set of defences. He was able to deal with his rage by taking an extreme Maoist Communist political position, ranting and raving about it, including his hate of America, etc., but at the same time he encapsulated this and focused it in the psychotherapy sessions. In contrast to many such fanatical individuals, he was able to keep himself from acting out these political feelings in any way or to engage in any destructive behavior. This seemed to form an intermediate position that enabled him to function and adapt to our society, get married, find long term respectable employment, and finally retire with savings and a pension. Understanding these ego operations empathically made it possible for the author to tolerate his views without either challenging them or agreeing with them and enabled him to come regularly and utilize supportive psychotherapy.

Adult↗