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DOI: 10.1177/036215371104100107 2011 41: 39Transactional Analysis Journal

Keith TudorUnderstanding Empathy

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Vol. 41, No. 1, January 2011 39

Understanding EmpathyKeith Tudor

AbstractThis article considers different understand-

ings of empathy in psychotherapy and trans-actional analysis, including Carl Rogersscontribution to the development and under-standing of empathy. A review of his neces-sary and sufficient conditions for therapeuticchange clarifies the bilateral and intersubjec-tive nature of empathic understanding, em-pathy, and empathic transactions. Variousaspects of empathy are elaborated in termsof Starks (1999) taxonomy of psychologies,and a fourth, two-person- plus psychology,is proposed to reflect an empathy that issociocentric rather than egocentric.

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A Brief History of EmpathyAesthetics. Empathy has a long history in

aesthetics, dating back to the eighteenth cen-tury, and, subsequently, in psychology, psycho-analysis, and therapy (a term I use to encom-pass psychotherapy, counseling, and counselingpsychology). The term Einfhlung, meaningaesthetic sympathy and later translated intoEnglish as empathy, was first used in print in1873 by the German philosopher Robert Visch-er (1847-1933) to designate the projection ofhuman feeling onto the natural world. The termwas and is used to describe aesthetic experi-ence both in and in response to various artforms (see Hunsdahl, 1967), an experience andprocess that acknowledges that our emotionalresponses to a piece or form of art are, in ef-fect, empathic projections onto an object, awork, an event, or even a person. Indeed, in hiswork on jokes and their relation to the uncon-scious, Freud (1905/1976) used empathy in thissense of aesthetic sympathy. However, Pigman(1995) has argued that empathy (Einfhlung)played a greater role in Freuds thinking than isconveyed in the Standard Edition which doesnot translate Einfhlung as empathy in a clinicalcontext (e.g., Freud 1916/1973). Later, Freud(1920/1955) described empathy as a mechanism

by means of which we are enabled to take upany attitude at all towards another mental life(p. 110). In his use of the term, Freud (1905/1976, 1916/1973) drew on the work of anotherGerman philosopher, Theodor Lipps (1851-1913), who had transferred the term from aes-thetics to psychology.

Understanding and Explanation. In psycholo-gy, empathy stands in a tradition that seeks tounderstand rather than to explain. Johann Droy-sen (1804-1884), the German historian andpolitician, was the first to contrast explanation(Erklren) with understanding (Verstehen) (seeVan Belle, 2005). This distinction, and the ela-boration of Verstehen, is also found in the workof the German philosopher Wilhelm Dilthey(1833-1911), who argued for a descriptive andanalytic psychology. Karl Jaspers, the Germanpsychiatrist and existential philosopher, basedhis work on psychopathology (Jaspers, 1913/1963) on this distinction, which, for him, pro-vided an organizing principle for nosology:The most profound distinction in psychic lifeseems to be that between what is meaningfuland allows empathy and what in its particularway is un-understandable, mad in the literalsense (p. 577). Jasperss acceptance of the dis-tinction between affective disorders and schizo-phrenia was, in part, based on the distinctionbetween those conditions with which one couldempathize and those that are less or not under-standable. The difference between explanationand understanding underpins the concept of em-pathic understanding in person-centered theoryand therapy and distinguishes it from othertherapies that seek to explain, analyze, and/orinterpret. Given his training and interest in psy-choanalysis, Eric Bernes own writings reflectthe tradition of explanation. It is only in thepast 20 years that a few writers within trans-actional analysis have developed the theory andpractice of understanding through empathy (seelater in this article). Although both explanationand understanding are important in therapy, thedistinction between them informs much thinking

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KEITH TUDOR

40 Transactional Analysis Journal

about empathy: Rogers (1951), for instance,distinguished between an empathic and a de-clarative attitude on the part of the counselor.

Empathy in Different Theoretical Orienta-tions. Empathy appeared in Jasperss existen-tial approach to psychiatry and psychology andin his work on General Psychopathology (Jas-pers, 1913/1963), in which he emphasized it asa criterion for diagnosing delusions. Theoristsand clinicians from other schools of psycholo-gy and psychotherapy have also used and devel-oped the concept, most notably Rogers (1951,1959, 1975/1980a) in client- or person-centeredpsychology; Kohut (1959, 1982) in self psy-chology; and Jacobson (1964) and Winnicott(1965) in object relations theory. More recent-ly, therapists within cognitive behavioral thera-py have been addressing the literature on em-pathy and developing their own conceptuali-zation of the nature and function of therapeuticempathy (e.g., Thwaites & Bennett-Levy, 2007).The contributions of a number of theoreticalorientations to the reconsideration of empathyhave been brought together in a useful volumeedited by Bohart and Greenberg (1997). Nowa-days, empathy is perhaps most associated withself psychology, and its views on empathy seemto receive more attention in theory, practice,and teaching/training than do those of Rogers.

In the rest of this part of the article, I reviewRogerss writings on empathy and the develop-ment of his ideas as well as those of otherswithin the person-centered approach, afterwhich I compare and contrast them with thoseof Kohut.

Carl Rogers on EmpathyRogerss first reference to empathy was in

his book Client-Centered Therapy (Rogers,1951), although in his first book, Counselingand Psychotherapy (Rogers, 1942), he did de-fine the basic hypothesis of this (then) newerapproach to psychotherapy in terms of the ef-fect on the client: Effective counseling con-sists of a definitely structured, permissive rela-tionship which allows the client to gain an un-derstanding of himself to a degree which ena-bles him to take positive steps in the light of hisnew orientation (p. 18). Later, commenting onresearch into the ideal therapeutic relationship

based on the work of therapists representingthree different theoretical orientations (Fiedler,1949, 1950), Rogers (1951), in his first explicitreference to the concept of empathy, suggestedthat the findings offered outstanding corro-boration of empathy and complete understand-ing on the part of the therapist (p. 54). Later inthe same work, Rogers placed empathy along-side warmth (later, unconditional positive re-gard) as two behavioral characteristics that areimportant in creating a nonthreatening, accept-ing atmosphere (p. 348), a reference that pre-dated his later (Rogers, 1957, 1959) work iden-tifying six necessary and sufficient conditionsfor growth and personality change.

In the seminal paper in which he outlined histheory of therapy, personality, and interperson-al relationships, Rogers (1959) defined empath-ic understanding this way: To perceive theinternal frame of reference of another with ac-curacy, and with the emotional components andmeanings which pertain thereto, as if one werethe other person, but without ever losing the asif condition (p. 210). The therapists empath-ic understanding of the client seems to be help-ful and potent in two ways. The first is that ithelps clients to identify, clarify, and then sym-bolize or find words for the nuances of theirown experience. This is consistent with whatRogers (1951) wrote about diagnosis: Thepurpose of the therapist is to provide the con-ditions in which the client is able to make, toexperience, and to accept the diagnosis of thepsychogenic aspects of his maladjustment (p.223). Elsewhere, Rogers (1975/1980a) put itthis way: True empathy is always free of anyevaluative or diagnostic quality (p. 154). Thesecond way in which empathy is powerfulfollows from this: A client who feels herself orhimself accurately understood and still ac-cepted feels less alienated, less alone, and morerelated to another human being.

The term empathic understanding may beconfusing. In person-centered literature it isoften used synonymously with empathy and isgenerally more often used by Rogers in hiswritings on the subject (Rogers, 1951, 1959,1961/1967b, 1975/1980a). It carries the conno-tation, however, that empathy is only or pre-dominantly a cognitive process. Others since


UNDERSTANDING EMPATHY

Vol. 41, No. 1, January 2011 41

have used a number of descriptors to extend theconcept of empathy beyond cognition orimplied cognition. One such term is visceralempathy, a phrase that I have been using forsome 15 years to describe the particular andoften specific somatic sensation experienced inresponse to the client and, often quite specifi-cally, to something she or he is reporting ordisclosing. Such somatic experiencing can behelpful in attuning to the client, but it can alsobe disturbing; either way, the therapist needs tomonitor such responses and to process theirmeaning and effects (see Rothschild with Rand,2008). Cooper (2001) referred to the term em-bodied empathy to describe the therapists em-bodied attunement, in which the therapist isresonating with the complex, gestalt-like mo-saic of her clients embodied being . . . [inwhich] the whole of the therapists body isalive in the interaction, moving and vibrating intandem with the clients experiencing (p. 223).In transactional analysis, Cornell (Cornell &Landaiche, 2007) has used the term somaticresonance to describe something similar.

The term empathic attunement is sometimesused synonymously with empathy but, in myview, confusingly so. More precisely, attune-ment refers to the therapists experience of at-tunement and is differentiated from the commu-nications that flow from that attunement. Sometheorists and practitioners, such as Stern (1985)and Erskine, Moursund, and Trautmann (1999),distinguish between affect attunement and thecognitive processes involved in empathy. Ers-kine and Trautmann (1996) view attunement asa two-part process involving empathy and thecommunication of that sensitivity (see later sec-tion on Empathy in Transactional Analysis).Attunement requires the therapist to tune into or resonate with the client. OLearys (1993)description of empathy caught something ofthis when he likened empathy to two tuningforks tuned in the same key: When one isstruck the other picks up the sound emitted bythe first while losing nothing of its own essen-tial nature. Empathy is tuning into the wave-length of the client. Counsellors must attunethemselves to that particular wavelength (p.113). Bohart and Rosenbaum (1995) used theterm in a similar sense of the therapist vibrating

in harmony with the client but also in thesense of amplifying on something the client hassaid. Although similar to attunement, the differ-ence between resonance and attunement is per-haps one of directionality: Attunement suggeststhat the therapist attunes to the client; reso-nance suggests that the therapist picks up some-thing from the client.

In another description, Rogers (1954/1967c)defined empathy in the context of acceptance:

If I say that I accept you, but know noth-ing of you, this is a shallow acceptance in-deed, and you realize that it may change ifI actually come to know you. But if I un-derstand you empathically, see you andwhat you are feeling and doing from yourpoint of view, enter your private world andsee it as it appears to youand still acceptyouthen this is safety indeed. In thisclimate you can permit your real self toemerge, and to express itself in varied andnovel formings as it relates to the world.(p. 358)In the same year that Rogers (1959) pub-

lished the major formulation of his theory,Kohut published his paper on Introspection,Empathy, and Psychoanalysis. In it he definedempathy as vicarious introspection, by whichhe meant that it is only through introspection inour own experience that we can learn and knowwhat it might be like for another person in asimilar psychological situation or circumstance.Later, Kohut (1984) defined empathy as thecapacity to think and feel oneself into the innerlife of another person (p. 82), a definition thatis similar to Rogerss (1961/1967b) description:

[Empathy occurs] when the therapist issensing the feelings and personal meaningswhich the client is experiencing in eachmoment, when he can perceive these frominside, as they seem to the client, andwhen he can successfully communicatesomething of that understanding to hisclient. (p. 62)Nearly 25 years after his first reference to

empathy, Rogers returned to the subject. Keil(1996) suggested that this was because of Rog-erss concerns about misunderstandings anddistortions concerning his conception of em-pathy. In an article published in 1975, Rogers


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(1975/1980a) reflected that I would no longerbe terming it a state of empathy, because I be-lieve it to be a process, rather than a state (p.142). He continued:

An empathic way of being with anotherperson has several facets. . . . It involvesbeing sensitive, moment by moment, to thechanging felt meanings which flow in theother person. . . . It means temporarily liv-ing in the others life, moving about it deli-cately without making judgments; it meanssensing meanings of which he or she isscarcely aware. . . . It includes communi-cating your sensings of the persons worldas you look with fresh and unfrightenedeyes at elements of which he or she is fear-ful. (p. 142)

This represents a shift in Rogerss (1959) think-ing about empathy as an as if state/attitude ofthe therapist to a description that emphasizes aprocess between therapist and client (1975/1980a), one that includes the therapist goingbeyond the experiencing of the client. (Thisshift parallels a similar change in Rogerss ap-proach to congruence as identified by Frankeland Sommerbeck, 2005, and referred to asRogers I and Rogers II.)

Other person-centered practitioners and theo-rists have developed Rogerss ideas on empa-thy. Those within the cognitive tradition ofperson-centered psychology coined the termempathic responding in order to stress, asWexler (1974) put it, the fact that [empathy]is not merely an attitude but a consistent styleof behaviors given as responses to the client(p. 96). In this tradition, an empathic responseis a deliberate and organized response to theclient:

When it is optimal, an empathic responseis a structure or group of structures thatmore fully captures, and better organizes,the meaning of the information in the fieldthat the client is processing than had thestructure(s) the client had generated him-self. (p. 97)Greenberg and Elliot (1997) expanded this

and identified five distinct forms of empathicresponding: understanding, evocation, explora-tion, conjecture, and interpretation. These varydepending on whose frame of reference is being

usedthat is, the therapists or the clientsand on the degree of new information that isgiven.

Rogers (1980c) referred to his person-centered psychology as an approach (see alsoEmbleton Tudor, Keemar, Tudor, Valentine, &Worrall, 2004; Wood, 2008) and, indeed, as AWay of Being (Rogers, 1980c). Interestingly, inthe second edition of his book The Interperson-al World of the Infant, Stern (1998) renamedwhat he had previously referred to as repre-sentations of interactions that are generalized(or RIGs) (Stern, 1985) as ways-of-being-with. He argued that by doing so he was de-emphasizing the process of formation in favorof describing the lived phenomenon in a moreexperience-near and clinically useful way(Stern, 1998, p. xv). This prefigures and is con-sistent with his more recent interest in thepresent moment in psychotherapy and everydaylife (Stern, 2004) and has informed interest inthe present in cocreative transactional analysis(see Summers & Tudor, 2000, 2005; Tudor,2003, in press).

Almost every approach to psychotherapyclaims the therapists empathy as central to itseffectiveness, and research in neurosciencesupports the development of empathy in sup-porting limbic resonance. However, with rareexceptions, neither therapists from other orien-tations nor neuroscientists acknowledge thework of Rogers or other person-centered theo-rists in the development of their understandingof this most important human quality and thera-peutic attitude. This is due, I think, to fourfactors:

1. There is a general view that Rogerian andperson-centered thinking and practice isbasic and (too) simple.

2. There has been a widespread associationof Rogerian and person-centered practicewith counseling (only) rather than psy-chotherapy, a distinction that has more todo with the organization and politics ofthe activity/profession then any essentialdifference (see Tudor, 1997) and one thatgenerally is not held within the person-centered approach.

3. There have been many misunderstandingsof and misconceptions about client-centered



Vol. 41, No. 1, January 2011 43

therapy and the person-centered approach(see, for instance, Miller, 1989, discussedon page 46 of this article). These havebeen identified and addressed by a num-ber of authors (see Barrett-Lennard, 1983;Mearns & Thorne, 2000; Tudor & Merry,2002; Wilkins, 2003).

4. A certain intellectual isolationism has ex-isted whereby practitioners and theoristsread within and develop their own par-ticular field but do not necessarily readmuch outside it or across theoreticalorientations. The result is that they canbecome somewhat parochial in their out-look and misinformed about theories, ide-as, and developments in other fields andapproaches.

Heinz Kohut and Carl RogersHeinz Kohut, at least in his early writings,

viewed empathy as more informative than cura-tive. Indeed, Stolorow, Atwood, and Brand-chaft (1992) used the term empathic inquiry(p. 2) precisely to emphasize Kohuts (1959)original conceptualization of analytic empathyas a unique investigatory stance. This does notmean that the therapist is asking questions;rather, it means that she or he is facilitating theunfolding and illuminating of the clients sub-jective world. Stolorow (1993) suggested thatthe term affective responsiveness should beapplied to Kohuts depiction of empathy as apowerful emotional bond in order to distin-guish between the two aspects of Kohuts viewand definition of empathy. Stolorow clarifiedthe relationship between these two aspects asan essential ingredient of the analysts attitudeof empathic inquiry is his commitment continu-ally to investigate the meaning of his affectiveresponsiveness, or its absence, for the patient(p. 32). Erskine, Moursund, and Trautmannpicked up on this aspect of empathy when theyreferred to inquiry as a central skill in effectivepsychotherapy (Erskine et al., 1999; Moursund& Erskine, 2004).

In general terms, self psychology describesany approach to psychology that places the selfas the central concept in its theory. More spe-cifically, it refers to a development in psy-chology that has its roots in psychoanalysis but

that places empathy rather than interpretation atthe center of its method and practice. In thisway, self psychology has helped to reclaim andrelocate the therapeutic and curative role ofempathy in the wider fields of psychoanalysisand psychotherapy. Furthermore, Kohuts workis generally viewed as providing a bridge be-tween psychoanalysis and humanistic psycholo-gy and psychotherapy. From a person-centeredperspective, this is a welcome development,and, indeed, much of the writing in this fieldechoes Rogerss own writings and even phrases.

The contribution of Rogers and other person-centered theorists to the understanding anddevelopment of empathy, however, was entire-ly unacknowledged by Kohut himself and rare-ly acknowledged or referenced by other selfpsychologists. Tobin (1991) reminded us thatRogers and Kohut were both at the Universityof Chicago between 1945 and 1957, and, whilethere is no record of the two men meeting,Elizabeth Kohut, a psychologist and Kohutswife, did have some contact with RogersandI, for one, cannot believe that Kohut did notknow of Rogerss work, especially on this sub-ject. Tobin also commented that, in his work,Kohut referred to few other writers who influ-enced him, so his lack of acknowledgment ofRogers may not have been a specific lapse orslight.

Less understandable, however, is the contin-ued, almost willful lack of sourcing, citing, andreferencing of Rogerss work among more re-cent self psychologists. In one volume editedby Jackson (1991), only one contributor (Don-ner, 1991) quoted Rogers on empathy (and thenonly once), and another (Ornstein, 1991) man-aged to discuss acceptance and understandingwithout citing or referring to Rogers at all. Cor-nell and Bonds-White (2001) perpetuated thesame mistake when they stated unequivocallythat the centrality of an empathic stance inpsychotherapy has emerged largely from thework of Kohut and other self-psychologists (p.78).

In 1986 Rogers wrote an article in which heoffered his own perspective on some of the simi-larities and differences between himself, Kohut,and Erickson. He acknowledged that he sharedwith Kohut similar ideas about fundamental


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human nature, which was, for Kohut, assertiveand affectionate, and about the self and therestructuring of the self through therapy. It isalso clear that Kohuts view of empathy asexperience-near observation equates withRogerss as if definition of empathy. Rogerscited Kohuts (1978) definition of empathyapprovingly: Empathy, the accepting, confirm-ing, and understanding human echo evoked bythe self, is a psychological nutrient withoutwhich human life as we know and cherish it,could not be sustained (p. 705). Rogers, how-ever, took issue with Kohut on several points:

1. Rogers pointed out Kohuts lack of trustin the actualizing tendency, citing Ko-huts (1981) paper in which he talkedabout his view that the analyst cures bygiving explanations

2. There are significant differences with re-gard to therapeutic intent. For Rogers,being in tune was, in itself, healing,confirming, and growth promoting, where-as for Kohut it was a preamble to thecurative explanation.

3. With regard to Kohuts view of the thera-peutic relationship, according to Rogers(1986), Kohuts was cooler and less per-sonal than Rogerss.

4. Rogers viewed Kohut as lacking interestin testing his theories.

Following Rogers, a number of writers havecommented on the similarities and differencesbetween the person-centered approach and selfpsychology: Stolorow (1976), Graf (1984),Kahn (1985, 1989a, 1989b, 1996), Bohart(1991), Tobin (1991), Warner (1997, 2000),Kahn and Rachman (2000), Stumm (2002), andTudor and Worrall (2006).

The two psychologies share similar views ofhuman nature, although both Kahn (1985) andStumm (2002) have argued that Kohut wasmore pessimistic in his view of the human con-dition, the self and self-development, and theimportance of the psychological climate. Bothapproaches draw on phenomenology and phe-nomenological method, similarly acknowledgethe difference between empathy and emotionalidentification, and apply their theories to socie-tal issues. They differ in their philosophical andintellectual heritage; their views of the potential

of human beings; about growth and the out-come of therapy; in their theories about changeor cure, disturbance, and transference; and inresearch methodology and therapeutic method(see Table 1).

Regarding empathy, the principle differenceis that, while Rogers and most person-centeredpractitioners view the therapists empathy as, initself, curative, Kohut (1982) viewed empathy,initially at least, as a mode of observation, at-tuned to the inner life of man (p. 396). In thissense, empathy is an investigative stance thatconstitutes the quintessence of psychoanalysis(p. 398); in other words, it is an information-gathering activity undertaken in order that thetherapist can make good interpretations. Ineffect, these differences represent the philo-sophical and historical difference between un-derstanding (Verstehen) and explanation (Erk-lren), respectively. At the same time, as Stolo-row (1993) pointed out, Kohut (1982) also de-picted empathy as a powerful emotional bondbetween people . . . [and that] empathy per se. . . has a beneficial, in a broad sense, a thera-peutic effectboth in the clinical setting and inhuman life, in general (p. 397).

From this we may speculate that the similari-ties between these two approaches may havebeen minimized by the way in which the differ-ent traditions of understanding and explanationcan be and can become polarized. In this age ofintegration, the challenge may be to find agenuine integration of both the informative andthe explanatoryand, indeed, the curative.One concept that may be useful in this endeav-or is Bubers (1962, 1963) view of compre-hension (Umfassung), which, for him, took inboth poles of empathy: that of being centeredin the other and in ones own existence. Ac-cording to Buber, comprehending is differentfrom looking at and from observing (and men-tally taking notes)and, by implication, fromexplainingbecause it carries a sense of beingexistentially affected by something or someone.Schmid (2001), a person-centered therapist,philosopher, and commentator on Buber, linkedthis to the importance of presence and arguedthat such comprehension

is only possible if I become present to theother: presence is the fundamental core of



Vol. 41, No. 1, January 2011 45

Table 1Differences between the Person-Centered Psychology of Rogers and the

Self Psychology of Kohut and Others (Tudor & Worrall, 2006)

Person-Centered Psychology (Rogers) Self Psychology (Kohut)Philosophical/Intellectual Background

Existential, humanistic frame of reference Background in psychoanalytic ego psychology

The Potential of Human BeingsBelief in the organisms tendency to actualize Kohuts concept of the tragic person is less optimistic

Growth and Outcome of TherapyIn the direction of greater independence Interdependenceand separation (autonomy) (from Kohuts ideas about necessary dependency of the self on external sources)

Theory of Change/CureExpansion of consciousness Strengthening of the self

SelfChanging, perceptual view (Rogers, 1951) As bipolar configuration (Kohut, 1977)

Self-DevelopmentFocus is in the present therapeutic situation Shows that certain categories of parental behaviors are also necessary attitudes for therapists

Theory of DisturbanceEtiologyDeficit model Dissociation model

EmpathyThe therapists attempt to perceive the internal Viewed as an information-gathering activityframe of reference of the other is itself curative (Kohut, 1982) . . . and in order to make(see Rogers, 1959). good interpretations and curative explanations

TransferenceThe therapist endeavors to understand and accept Transference is a manifestation of the clientstransference attitudes but does not foster dependence manner of organizing her or his experience

Theory and Research MethodologyImportance given (especially by Rogers) to theories Subjective experience is only accessibleTheories being testable by empirical means and through introspection and empathyoperationalized (see Rogers, 1986)

Re: Therapeutic MethodAgainst interpretation Against unempathic interpretations but in favor of generic interpretations linking present events with past experiences

this way of relating and perceiving. . . . Em-pathy is an expression of presence, becauseit is, in existential wonderment, related towhat the Other is experiencing. (p. 58)

Empathy in Transactional AnalysisIn his writing, Berne mentioned empathy

only once. In an early paper published in 1955(Berne, 1955/1977), he commented briefly (in

two sentences) on the distinction between em-pathy and intuition, arguing that while empathyhas a connotation of identification, intuitiondoes not, and, rather, that it has to do with theautomatic processing of sensory perceptions(p. 95). Bernes lack of reference to empathy isno accident: He did not consider it a technique,let alone an attitude, and it did not appear asone of his therapeutic operations (Berne, 1966).


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As Cornell and Bonds-White (2001) pointedout,

His [Bernes] transactional analysis wasintended to unsettle a clients familiar, de-fensive frame of reference through de-scription, confrontation, interpretation, andhumor. It seems quite clear that Bernesintent, consistent with a classical psycho-analytic position, was to alter the intrapsy-chic structure and function of the clientthrough clarifying interventions, not throughoffering a corrective relationship. (p. 73)

Bernes transactional analysis thus reflects, inthe language of Starks (1999) meta-analysis ofmodes of therapeutic action, a one-personpsychology (for further discussion of this, seepage 49).

In the 20 years following Bernes death,there appears to have been a similar lack of in-terest within transactional analysis in the sub-ject of empathyor, perhaps, the elaborationof empathy. Indeed, in over 35 years of theTransactional Analysis Journal (TAJ) and over1,500 articles, there are only two specificallyon the subject of empathy: Payton, Morriss,and Beale (1979) and Clark (1991), the formerof which is a report on the effects of transac-tional analysis instruction on students abilityto recognize empathic responses and to discri-minate empathic from nonempathic responses.A review of TAJ articles published betweenJanuary 1971and January 2008 (see Summers,2008) reveals some interesting statistics:

While only two articles have empathyor empathic in their titles, some 253 men-tion empathy, empathic, or empathetic.

Interest in the subject appears to have in-creased over the years; an analysis ofthese 253 articles by decade reveals thefollowing distribution: 1970s9 articles,1980s53, 1990s87, and in the sevenyears from January 2000 to January 2008104.

Of the 253 articles that mention the sub-ject, only 36 have three or more mentionsof empathy, empathic, or empathetic, andof these, only 8 deal with the subject inany detail, all of which have been writtenin the last 17 years.

In addition, some transactional analysis authors

have written about empathy in books, notablyErskine, Moursund, and Trautmann (1999);Moursund & Erskine (2004); and Hargadenand Sills (2002). In this section I review theseideas in the chronological order of their devel-opment.

The Empathic Transaction (Clark). In her1991 article, Clark introduced the concept ofthe empathic transaction, suggesting that itdemonstrates the importance of regulating theintensity and directness of transactions duringdifferent phases of treatment (p. 92). Clark didnot quote Rogers directly, but she cited anotherauthor, Miller (1989), who referred to Rogersbut misrepresented him. Specifically, Millerclaimed that Rogers identified three variablesthat were necessary and sufficient when, infact, Rogers identified six: psychological con-tact between client and therapist, client incon-gruence, therapist congruence, unconditionalpositive regard (or acceptance), empathicunderstanding, and the clients perception ofthe therapists acceptance and empathy. Ac-cording to Clark, an empathic transaction com-prises two parts: the therapists expression ofunderstanding of the patients experience andthe patients confirmation that he or she hasbeen understood (p. 92). Drawing on Bernes(1963) ideas about phases of treatment, Clarktalked about the intensity of the therapiststransactions in different phases of therapy: de-contamination and deconfusion. Although Clarkdid not diagram this transaction, from what shesaid about direct transactions, I think herdescription of the empathic transaction is accu-rately represented in Figure 1.In this analysis oftransactions, however, Clark did not accountfor the first transaction, that is, the stimulusfrom the client.

Empathy and Integration (Erskine, Mour-sund, and Trautmann). In their book BeyondEmpathy, Erskine, Moursund, and Trautmann(1999) characterized the qualities of attune-ment and involvement and the skill of inquiryas central to effective psychotherapy. They basedall three elements on empathy but claimed thatall go beyond empathy in some way, al-though it is not clear precisely how or in whatways. In a subsequent book, Moursund and Ers-kine (2004) reviewed the literature on empathy;



Vol. 41, No. 1, January 2011 47

Figure 1The Empathic Transaction (based on Clark, 1991)

cited Rogerss development of empathy (al-though they, too, misrepresent his theory oftherapeutic conditions); and drew on Tropp andStolorows (1997) work to advocate for an ac-tive, inquiring kind of empathy. Moursund andErskine (2004) claimed that for relationship-focused integrative psychotherapists, empathyprovides a foundation upon which additionaltherapeutic activities are built (p. 95); theyagain identified these as attunement, inquiry,and involvement. Moursund and Erskine com-mented that these activities are enhancements

and intensifications of the empathic process(p. 95) and categorize them as beyond empa-thy (p. 95). The authors, however, appearambiguousand ambivalentabout whetherthe activities they are promoting are aspects,subdivisions, or extensions of empathy. Thisambiguity is important not only in terms of thedevelopment of theory but also because of thecentrality of empathy in their approach to trans-actional analysis and psychotherapy.

From Therapeutic Operations to EmpathicTransactions (Hargaden and Sills). In their book


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Figure 2The Empathic Transaction (Hargaden & Sills, 2002, p. 33)

book Transactional Analysis: A Relational Per-spective, Hargaden and Sills (2002) drew onClarks work on the empathic transaction anddiagrammed the empathic transaction as repre-senting a series of complementary transactionsbetween the Adult of the client and the thera-pist and complementary ulterior transactionsbetween the clients Child and the therapistsAdult (p. 33) (see Figure 2). They emphasizedthe importance of the ulterior transaction inresponding with empathy and respect to thecontaminated Adult of the client and in estab-lishing an empathic bond that, eventually, makesit possible for the client to feel secure enoughat an unthought level to revive unmet needsand suppressed developmental needs (p. 33).

Hargaden and Sills (2002) went on to re-frame Bernes (1966) therapeutic operations interms of empathic transactions, as part of whichthey added holding to Bernes sequence (be-fore crystallization). They made the point thatempathic transactions are fundamentally differ-ent from the original Bernean concept of opera-tions and argued that there are a number of ad-vantages to their reformulation:

1. It brings empathy into the context of suchoperations or transactions.

2. The use of the word transaction acknowl-edges the connectedness of both therapistand client: In other words, empathy is notsomething that can simply be given, italso needs to be received. This is a point



Vol. 41, No. 1, January 2011 49

that Rogers (1957, 1959) emphasized andthat I discuss further later in this article.Some may argue that this sense of con-nectedness is implicit in the concept of atransaction because it comprises both astimulus and a response; thus, a stimulusthat does not elicit a response is not atransaction and does not make a connec-tion. However, while the stimulus-responsemodel of transactions derives from be-haviorism, Hargaden and Sillss (2002)conceptualization of transactions drawson a more relational and intersubjectiveunderstanding and, thereby, gives greatersignificance to the connection betweenpeople in the communication of empathy.

3. The use of the word transaction acknowl-edges the ulterior, nonverbal element tothe exchange.

4. The use of the phrase empathic transac-tions acknowledges the use of subliminalthinking.

In their reworking of Bernes therapeutic op-erations, Hargaden and Sills (2002) developedthe concept of empathic transactions as a formof analysis and interpretation and thus devel-oped a Kohutian perspective on empathy.

Elsewhere (Tudor, 2011), I have developedand diagrammed a cocreative perspective onthe empathic transaction.

Empathy in a Relational ContextFrom the discussion so far, it is clear that

there are different understandings and defini-tions of empathy. To clarify the significance ofthese differences, I develop Starks (1999) tax-onomy of psychologies, by which she distin-guished between three different, although mu-tually enhancing, modes of therapeutic action.Table 2 notes Starks different psychologies,with the addition of a two-person-plus psy-chology, and summarizes their respective dif-ferent influences, which I refer to as centered-ness and foci. Other columns in Table 2 giveexamples of different views of empathy thatreflect each mode and notes criticisms or limi-tations of each mode.

One-Person Psychology. In the first mode,the goal of treatment is a strengthening of theclients ego through insight facilitated primarily

by the therapists interpretations. In this modeor model, the therapist is not a participant in arelationship but, according to Stark (1999), anobjective observer of the patient (p. xvi). Shecontinued, The therapist conceives of her posi-tion as outside the therapeutic field and of her-self as a blank screen onto which the patientcasts shadows that the therapist then interprets(p. xvi). This mode is more often associatedwith the interpretive model of classical psycho-analysis and ways in which empathy is used tointerpret, evoke, and inquire, whether from ahermeneutic perspective or not, so as to keepthe therapist as a distant as if figure (seeKeil, 1996). However, many cognitive behav-ioral therapists, as well as humanistic thera-pists, also use empathy in this way, or, perhapsmore accurately, their empathy reflects a one-person psychology. When we say to a client,You look sad, we are, in effect and in es-sence, offering an interpretation based on someobservationusually of her or his eyes, face,and postureas well as the content and tone ofwhat the person is saying. Furthermore, there isat least one form of empathyhermeneuticempathy (Keil, 1996)that describes the situa-tion when the therapist understands more thanthe client and differs from the client in what sheor he understands. On the basis that therapy isa hermeneutic or interpretive activity, Keil ar-gued that empathic understanding necessarilyhas to go beyond the as if understanding andone-to-one relationship, by which he means arelationship based on a one-person psychology.Keil went on to identify a number of steps inrealizing hermeneutic empathy, beginning withthe therapist perceiving and recognizing her orhis own reactions to the behavior and expres-sion of the client and, later, recognizing theimportance of nonacceptance and nonunder-standing.

One-and-a-Half-Person Psychology. Stark(1999) introduced what she referred to as thesecond mode of psychology by means of a briefhistory of the shift in the etiology of psycho-pathology from nature to nurture, a shift thatwas influenced by object relations and self psy-chology. As a result, Stark argued, The locusof therapeutic action shifted from insight byway of interpretation to a corrective experience


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Table 2Understandings of Empathy in Terms of Starks Modes of Therapeutic Action

Psychology orMode ofTherapeuticAction (basedon Stark, 1999)

Influence,Centeredness,andRelationship

Focus Empathy (Examples) Criticisms/Limitations

One-personpsychology

Unidirectionalinfluence

Patient/client-centered

Yourelationship

Structuralconflict,impairedcapacity,andrelation-ships withinthe person

Accustom yourself to give carefulattention to what others aresaying, and try your best to enterinto the mind of the speaker(Aurelius, 1964, p. 104).I and my colleagues realized thatthis empathic listening providedone of the least clouded windowsinto the workings of the humanpsyche, in all its complex mystery(Rogers, 1974/1980b, p. 50).

The endlesstolerance ofthe clientsneeds canappearquintessen-tionally nar-cissistic (H.Hargaden,personalcommunica-tion, 3October2005)

One-and-a-half-personpsychology

Unidirectionalinfluence

lPerson-centered

I-Itrelationship

Structuraldeficit,correctiveexperience,consolida-ting the self

Empathy involves a continuousprocess of checking with the clientto see if understanding iscomplete and accurate. It iscarried out in a manner that ispersonal, natural, and freeflowing: it is not a mechanical kindof reflection or mirroring (Rogers& Raskin, 1989, p. 189).

Two-personpsychology

Bidirectionalinfluence

Persons-centered,relationship-centered

I-Thou,Thou-I, Werelationship

Oninteractiveengage-ment,enact-ments, thetherapeuticrelation-ship,includingfailures

Empathic understandingunderstanding with a person, notabout him (Rogers, 1952/1967a,p. 332)When you live in the shadow ofinsanity, the appearance ofanother mind that thinks and talksas yours does is something closeto a blessed event. Like RobinsonCrusoes discovery of footprintson the sand (Pirsig, 1974/1991,p. 263).

Psycho-therapy canbe con-sidered to bean attempt tocarry outphenome-nology deux(Loewenthal& Snell,2003, p. 12).

Two-person-pluspsychology

Multidirectionalinfluence

Socio-centered

I-Thou-Them,We-in-contextrelationship

Context,environ-ment

Empathy . . . [is] in itself ahealing agent. It is one of themost potent aspects of therapy,because it releases, it confirms, itbrings even the most frightenedclient into the human race. If aperson can be understood, he orshe belongs (Rogers, 1986, p.129).



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by way of the real [therapeutic] relationship(p. xvii). However, this is more of an I-Itrelationship than an I-Thou or Thou-I rela-tionship and hence the designation of this modeas a one-and-a-half-person psychology. In thismode, empathy may be viewedand experiencedas a way of being on the part of the therapistby means of which the client may emerge withgreater self-understanding of herself or himself,others, and the world. The classical Rogerianempathic listening, together with reflection, isan example of this mode, and, indeed, Starkclassified Rogers (1961/1967b) as a therapist inthis mode or model. One example of empathyin this mode is when, as therapists, we checkout our understanding of what the client hassaid or meant. Brodley (2001), a leading expo-nent of the nondirective approach to therapy,was explicit about this:

I make empathic understanding responsesprimarily in order to check my accuracywith my clients. . . . I want to know wheth-er my inner understandings, that I havecommunicated as best I can, are accurateaccording to the client. Empathic respon-ses express my perceptions of my clientsintended communications. (p. 19)

Arguably, working in this mode requires thetherapist to have the kind of comprehensionto which Buber referred (described earlier).

There are criticisms of empathy or how em-pathy can be used in these two modes. Slavinand Kriegman (1992) argued that for the thera-pist to try to remain exclusively attuned todominant themes and meanings in the clientssubjective world can be a self-protective stra-tegy on behalf of the therapist (p. 252), onethat can be experienced by the client as con-trolling and emotionally impersonal. Indeed,as if empathy can be reflective of what Deutsch(1934) described as an as-if personality, inwhich affective relationships with others arebarred due to a pseudoidentification. OHara(1997) viewed these conceptions of empathy asmodernist and egocentric. In a contribution toan Internet discussion group, Helena Hargaden(personal communication, 3 October 2005)suggested that therapy based on person-centeredor self psychological perspectives, with theirfocus on endlessly tolerating the clients needs

for mirroring and twinship, can sometimesseem to be quintessentially narcissistic.

Two-Person Psychology. The third psycholo-gy identified by Stark (1999) conceives oftherapy as interactive engagement with anauthentic other (p. xix). In other words, whatheals is the therapeutic relationship itself, faci-litated by empathic attunement and resonance.In this mode, client and therapist create and co-create an interactive dyad in which each affectsthe otherand each recognizes that she or heaffects the other. This is sometimes referred toas a person-to-person relationship or, followingBuber (1937), an I-Thou relationship. In thismode, more attention is paid to the processingof inevitable empathic failure and misattune-ment on the part of the therapist (e.g. ,I thinkI missed you there) as well as to ruptures inthe relationship. This is reflected in the person-centered literature that has an interactionalorientation (see van Kessel & van der Linden,1993) and focuses on empathy as an aspect ofthe between or the interpersonal encounter (seeBarrett-Lennard, 1997; Myers, 1999; Schmid,2006), perspectives that highlight the reflectiveand cocreative nature of empathy. Although thishas echoes of Sullivans interpersonal therapy,and Rogers (1951) acknowledged the threadsof interconnectedness with [certain] modernformulations of psychoanalytic thinking (p. 4),including Sullivan (along with Horney andAlexander and French), Rogers only specifi-cally cited Sullivan (1945) with reference to hisviews on the forward direction of the organism.

Schmid (2001, 2006), in particular, made animportant contribution to the development of adialogical person-centered therapy. He madethe point (Schmid, 2006) that, as it is the otherwho calls the I into service, this relationshipis more accurately described as a Thou-I re-lationshipwhich, of course, also reflects a fo-cus or centeredness on the client. More broad-ly, this mode reflects the widespread interest inthe therapeutic relationship across theoreticalorientations and what Mitchell (2000) referredto as a relational turn (p. xiii) in psychothera-py. In this mode, empathy, from the therapistspoint of view, is for and with the other and withthe relationship and hence the therapists com-ments on the relationship (e.g., It seems like


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we both talked past each other there). In thecontext of sociocentric psychology, as distinctfrom egocentric psychology, OHara (1997)coined the phrase relational empathy, which,she argued, offers a view of empathy as contex-tual awareness and as a stateor processofconsciousness that is based on and reflects arelational knowing. She contended that em-pathy has a more respected role in sociocentrichuman relations than it typically does in ego-centric cultures (p. 303) and that in such rela-tions and cultures empathy is not a poor rela-tion to objective interpretation (p. 303).

The criticism of this mode of therapeutic ac-tion is encapsulated in Loewenthal and Snells(2003) suggestion that psychotherapy can beconsidered to be an attempt to carry out phe-nomenology deux (p. 12).

A Fourth Mode? Two-person psychology,psychotherapy, and other activities help healingand change take place in a social context, andthat social context has an evident effect onwhat happens in the consulting roomand, in-deed, even on whether the client gets to andcontinues to attend therapy. Furthermore, forsome therapistsand, within transactionalanalysis, those who view TA as a social psy-chology and who draw on the radical psychia-try traditionthe context that clients bring intothe consulting room is an important focus fortherapy. Given the significance of client factorsand extratherapeutic factors, and in acknowl-edgment of an interest in the social context oftherapywhat I have referred to as another,social turn in the field of psychotherapy (seeTudor, 2010)I propose a fourth mode oftherapeutic action: a two-person-plus psycholo-gy. This phrase and mode acknowledges thesignificance and impact of these factors and ofthe social context of the client, the therapist,and the therapyand of the therapists and cli-ents empathic relationship with such factors.

Two-Person-Plus Psychology. Alongside theinterest and development in ideas about thetherapeutic relationship or therapeutic relating(see Summers & Tudor, 2000; Tudor, 2008b),there is an increasing acknowledgment of theimportance to psychotherapy outcome of clientfactors as well as other extratherapeutic factors(i.e., factors outside therapy that are therapeutic;

see Bohart & Tallman, 1999; Bozarth, 1998;Duncan, Miller, & Sparks, 2004; Miller, Hub-bard, & Duncan, 1995). These encompass theclients active participation in therapy and heror his proactive choice and realistic expecta-tions of therapy as well as her or his levels ofpsychosocial functioning, secure styles ofattachment, psychological mindedness, and so-cial support. As Horney (1945/1999) put it,Life itself still remains a very effective thera-pist (p. 240). One example of empathy in thismode is Rogerss (1986) definition of empathyas in itself a healing agent (p. 129). Hecontinued, It is one of the most potent aspectsof therapy, because it releases, it confirms, itbrings even the most frightened client into thehuman race. If a person can be understood, heor she belongs (p. 129). Elsewhere, Rogers(1975/1980a) described one of the profoundconsequences of empathy succinctly: Empathydissolves alienation (p. 151). It is no accidentthat those therapists and otherssuch as com-munity and youth workers as well as politicalactivists who focus on the social/political worldoften work and organize in groups and com-munities, and that those who analyze alienation(see, for instance, Agel, 1971) and psycho-pathology as forms of alienation (see, for in-stance, Tudor & Worrall, 2006), often worktherapeutically in and with groups.

We can understand more fully the signifi-cance of this social, connecting aspect of em-pathy if we also refer to Angyal (1941), a psy-chologist whose work influenced Rogers. Ang-yal explored the concept of homonomy, whichhe defined as the tendency to conform to, unitewith, participate in, and fit into superindividualwholes (p. 182). He suggested that this ten-dency or trend, this urge to belong to some-thing larger than oneself, is a source of pro-found motivation for human behavior (p.182). As human beings, we tend or trend to-ward both autonomy and homonomy in a worldthat is heteronomous or other. As Angyal put it,The organism lives in a world in which thingshappen according to laws which are heterono-mous from the point of view of the organism(p. 33). Empathic understanding, resonance,and, specifically, visceral and relational em-pathy are ways of satisfying this trend toward



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homonomy for both client and therapist. Whenone understands the other, both belong tosomething larger and more inclusive than eitherdoes individually. While the concept of autono-my is familiar and well-articulated in transac-tional analysis, from Berne (1964/1968) on-ward, there is, apart from my work, only oneother reference in the transactional analysisliterature to the concept of homonomy in anexcellent article written by Massey (2007).Rogers and Angyal knew of each others work:Rogers (1951, 1959) cited Angyal (1941), andAngyal (1965/1973) referred to Rogers whenhe acknowledged that

with patients whose emotions are not, orno longer, completely submerged or falsi-fied, a sensitive recognition of all theirfeelings by the therapist can do much toincrease the patients awareness of hismental states. Because of this greater dif-ferentiation, and also because the therapistnaturally resonates to genuine undistortedfeelings, this process also furthers theirgrowth. This is one reason why reflectionof feelings advocated and practiced byRogers and his followers often proves soeffective. (p. 290)Within transactional analysis there are no

journal articles on the subject of belonging, al-though it is the subject of some discussion inarticles by Caracushansky (1980), Caracushan-sky and Giampeitro (1987), and Shadbolt(2004). Maslow (1954) placed belonging be-low but, reading from the bottom up, beforeself-actualization in his hierarchy of needs, andit is implied in some of the relational needsidentified by Erskine and Trautmann (1996)(e.g., to feel validated, affirmed, and signifi-cant; to be accepted by a stable, dependable,and protective other; to have an impact on oth-ers; and to express love). Moiso (1999) expli-citly identified the drive to belong as one of thethree drives that derive from Bernes conceptof human hungers. He recognized this as thefirst permission essential to the child and,therefore, that the injunction Dont Belong,together with Dont Be and Dont, is a proto-injunction. Similarly, Allen and Allen (1999)considered that permission to feel that one be-longs is one of a number of major permissions.

In this fourth mode, the focus of the thera-pists empathy is with the clients relationshipwith the extratherapeutic factors that support ordetract from her or his life, including her or hisrelationship with therapy. The therapist paysattention to the clients sense of connectionwith and/or disconnection from her or his worldand of belonging to and/or alienation from theworld, including relationships with her or hisfaith, ancestors, and natural environment (e.g.,land, river, and mountains). Some therapistsexplore these relationships with the client byphysically moving out of the frame of the con-sulting room into the environment. Whether ornot client and therapist supplement or comple-ment talking with walking, it is clear that two-person-plus psychology acknowledges the so-cial, cultural, and environmental context of theclient and that empathy in this mode acknowl-edges the holistic and contextual client.

SummaryThis article has argued that the different

meanings of empathy have not been made ex-plicit in the transactional analysis literature andthat a fuller understanding of Carl Rogersswork on empathy, in the context of his neces-sary and sufficient conditions for therapy, ex-pands the understanding of empathy and its ap-plications in TA. The article has sought to clari-fy different perspectives on empathy in trans-actional analysis, an analysis that also serves asbackground for a separate article that elabo-rates a cocreative perspective on empathy(Tudor, in press). Finally, the article suggestsan addition to Starks (1999) taxonomy of dif-ferent psychologies, one that acknowledges theimpact and contribution of extratherapeutic fac-tors and context on the client. This perspectivereflects and enhances transactional analysis asa social psychology.

Keith Tudor, M.A., M.Sc., CQSW, Dip.Psychotherapy, Certified Transactional Ana-lyst (psychotherapy), Teaching and Super-vising Transactional Analyst (psychotherapy),is an associate professor and program leaderin the Department of Psychotherapy, AucklandUniversity of Technology, Aotearoa New Zea-land. He can be reached at Keith Tudor,


KEITH TUDOR


Private Bag 92006, Auckland 1020, New Zea-land; e-mail: [email protected] . The auth-or is grateful to two anonymous reviewers fortheir helpful comments on this article; to BillCornell for his editorial facilitation and hissuggestion of the term two-person-plus psy-chology; and, as ever, to Mick Worrall for hiscontribution to the development of these ideasand their collaboration on this subject in thecontext of their writing and various publica-tions on person-centered psychology.

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2011 World TA ConferenceBilbao, Spain * 7-9 July 2011

Cosponsored by ITAA, EATA, and ATAA

Training Endorsement Workshop: 2-4 JulyExams: 5-6 July

ITAA Board Meetings: Mon. & Tues. 4-5 July and the morning of Sun. 10 July

It is a great pleasure to invite you to come to Bilbaoa small city in the Basque country of northernSpainto celebrate together our 2011 Transactional Analysis World Conference. The conference will beheld in the antique buildings of Deusto University, situated on the Nervion River across from the Guggen-heim Museum. At the TA Conference we are going to face and explore the universal experience of TheChallenge of Growth. The transactional analysis concepts of awareness, intimacy, spontaneity, and,obviously, autonomy are all about the challenge to grow at every developmental stage in our lives. Theentire organizational team joins me in encouraging you to come and share with us this opportunity forlearning and thinking together. You will find a warm atmosphere and feel very welcomed in our city,Bilbao. Here you will enjoy our famous gastronomy, the picturesque old town, and perhaps even visitingour beaches and mountains. It is an honor for us to tell you, Ongi Etorri Bilbo ra! which in the Basquelanguage means Bienvenid@ a Bilbao! or You are very welcome to Bilbao!

Amaia Muriz-Etxabe, Chairperson

www.TAbilbao2011AT.com


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