Empathy and sympathy in psychotherapy

Journal/Book: Dynam Psych. 1997; 30: Kantstrasse 120/121, D-10625 Berlin, Germany. Pinel-Verlag Fur Humanistische Psych Philos. 28-34.

Abstract: The concepts of empathy and sympathy became part of the psychiatric discussion through the importance of ego-psychology. The concepts of the ego developed by the author's father, Paul Federn, give great importance to empathy, ego-states, ego-feelings and ego-boundaries. In contrast to Freud Federn assumes, that the ego of a child exists from birth on, but in the early symbiotic time it is unseparated from the mother. Disturbances between mother and child will occur, if the ego-boundaries of the mother do not exist or are hostile against the child. Under constructive developmental conditions in the continuing ego-development of the child, the ''I am me'' will develop into a ''I am we'' and finally into a we-feeling. In fact, Aristoteles described with the ''zoon politikon'' a social being. With increasing age of the child and the opening against the world of things and of human beings a stronger ego-feeling for the own self will develop. The author distinguishes between bodily ego-feeling and a mental ego. In psychotherapy, we talk about empathy, if the cathexis of the ego-boundaries of the therapist agree with the ego-boundaries of the patient. For the weak ego it is necessary to seek the relatively stronger sides of the personality and to build up the ego from there. When the bodily ego feelings are stronger than the mental ones, the body functions are used in the treatment. In the cases of antisocial behaviour it will be tried to develop a we-feeling, and with the dissocial disturbances the treatment will try to lead the aggressive impulses into social channels. The therapist must be able to adapt the cathexis of his ego-boundaries to those of the patient and he must be able to lend part of his ego to the patient. Therefore it is necessary to acknowledge the ego-states of the patient and to make a temporarily vertical splitting. Empathy is always important because without this no real relationship with the therapist or counsellor will ever develop. Sympathy may do with the neurotically disturbed patient, but the ego-disturbed person needs empathy in order to be reached.

Note: Article Federn E, Kolingasse 20-11, A-1090 Vienna, AUSTRIA

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