Issue 16 / 18 October 2010

THE “science of empathy” might sound like a contradiction in terms, but could this new field of knowledge help doctors improve clinical outcomes for patients and reduce their own risk of burnout?

Psychiatrist Helen Reiss thinks so.

Neuroimaging is helping us understand how our brains process the suffering of those around us and how we might regulate our empathic responses, this clinical associate professor from Harvard Medical School writes in the latest issue of JAMA.

When we observe another person in pain, imaging shows that we activate similar neural circuits to those that light up when we are in pain ourselves, but in attenuated form.

We literally “feel their pain”, just at a lower dose.

“This enables observers to experience another’s pain to the extent that it may motivate an empathic response but not overwhelm the observer with personal distress,” Reiss writes in JAMA.

Even more fascinating is research suggesting we may have some ability to control the level of our response.

One MRI study found a stronger activation of pain circuits in the brain of people told to imagine another person’s pain was happening to them, but reduced activation when told the other person’s pain was part of an effective medical treatment.

Why might the neuroscience of empathy be particularly important for doctors?

Reiss argues empathy is “an important component of clinical competence”, allowing doctors to obtain better information from patients and improving patient outcomes in areas as diverse as immune function, length of hospital stay post-surgery and strength of placebo response.

Of course, you can have too much of a good thing.

A doctor who shared too deeply in their patients’ suffering could easily get overwhelmed, with potential consequences for their own health and ability to do the job.

So perhaps it’s not surprising that research suggests we sometimes teach young doctors to be less empathic.

“Empathy begins to decline in the third year of medical school for complex reasons, including an emphasis on emotional detachment and clinical neutrality, over-reliance on technology that limits human interactions, lack of role models, and inappropriate treatment of medical students,” Reiss says.

Perhaps the findings of neuroscience will help to open up a middle way.

If we could train young doctors in evidence-based techniques to regulate their empathic response, allowing them to turn the dial up or down as the situation required, we might make it easier for practitioners to show they care without the risk of burning out.

Jane McCredie is a Sydney-based science and medicine writer. She has worked for Melbourne’s The Age and contributed to publications including the BMJ, The Australian and the Sydney Morning Herald. She is also a former news and features editor with Australian Doctor. Her book, Making girls and boys, on the science of sex and gender, will be published by UNSW Press early next year.

Posted 18 October 2010

One thought on “Jane McCredie: Feeling the pain but not the strain

  1. Sarah says:

    I’m so disappointed at the lack of empathy in many young doctors. Surely most have entered the profession because of some kind of feeling to help mankind. It is probably as important to feel empathy towards our patients as to have clinical skills, because in that way we can be attuned to our patients’ symptoms and signs which may help us in the process of diagnosis and healing.

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