High levels of empathy are key to the MI guiding style. Empathy has been misunderstood as the expression or demonstration of kindness, agreement, acceptance, or concern for the patient. It is more than that. Empathy is not sympathy, ”poor you”, nor is it “I’ve had the same problem”.
In Motivational Interviewing, empathy is simply the demonstration of a keen but neutral curiosity for the patient’s ideas and attitudes regarding all sides of the behavior change being proposed. In this setting, empathy refers to the idea that you “get” the other person. You really understand their point of view about this proposed change. And you have the ability to communicate your empathy.
This can be best understood by thinking about your own experience with other people. Think about someone in your life who is a good listener, advisor, counselor, or friend. The chances are this person understands who you are, and likes you with all your good points and flaws. How can you tell this is true? Usually it’s because they let you know that they understand, and you are not only okay with them, but they really like you! In MI, empathy is demonstrated through the use of effective listening and communication skills, not through any measure of smiles, kind words, or enabling gestures. They communicate this understanding by using different types of reflections.
It is important that the clinician understand all sides of the patient’s situation, both the arguments in favor of changing and those against a decision to change. Accurate empathy refers to as complete an understanding as possible, so that the clinician really understands and can let the patient know they understand.
This demonstration of empathy goes a long way in promoting health behavior change. I encourage you to think about how you express empathy with your clients, patients, colleagues and friends. How could you improve upon this skill?
