Walking out of my doctor’s office, I paused and wondered if he really understood how much pain I am feeling every day. I’ve had the same feeling with family and friends: I can talk to them about what I feel, but without them feeling the same physical sensations, can they really understand what I am going through? Therefore, when I heard about research on the “hot/cold empathy gap” between doctors and patients, my ears perked up.
According to a study done by Dr. George Loewenstein, one of the difficulties for patients getting appropriate care for pain is the “hot/cold empathy gap.” Patients who are in pain are in a “hot” psychological state. Doctors, on the other hand, are usually in a calm, “cold” state of mind while working. The problem is that people in a “cold” state of mind are not very good at estimating how differently people in a “hot” state think – and vice versa. That is, we over-generalize how we feel onto others: if a mother is feeling chilly, she is likely to insist her child must put on a sweater, even if the child is sweaty from rough-and-tumble play.
In medical settings, this human difficulty to empathize with experience different from our own makes it hard for doctors to truly understand their patients, which may lead to inadequate care. For example, a doctor who is feeling comfortable and content is likely to underestimate the pain of his or her patients, whereas patients whose doctor had a recent experience with pain are likely to get more empathetic care.
Why doctors do not empathize?
Dampening one’s empathy serves a protective function for medical professionals. If an obstetrician would feel 100% of birth pains while working, he or she would quickly consider a career change. Therefore, keeping emotional distance can help doctors to keep working. Research on acupuncturists found that when they saw needles inserted into patients, their emotion regulation and memory
centers of the brain lit up. In contrast, the pain detection centers become activated when non-acupuncturists saw the same. This means that acupuncturists’ brains were actively putting aside the vicarious pain of seeing someone being pricked with needles, whereas the brains of lay people were focusing on imagining the sting.
Empathetic doctors help their patients feel better
If lacking empathy makes it harder for doctors to understand and diagnose patients, but protects them from the unpleasantness of having to feel every pain of their patients, what is then the right amount of empathy? Interestingly, whether a doctor really feels your pain is not important after all. Rather, what matters is that you feel they understand where you are coming from.
Dr. David Rakel trained doctors on how to come across as empathetic and found that patients who felt that their doctors understood them recovered faster from colds. In short, his research shows that feeling understood by your doctor is just as effective for colds as antiviral medication. Of the 84 patients that gave their doctors perfect scores on showing empathy, all had a measurable boost in their immune system.
From my work experience as a therapist, I completely understand the importance of feeling understood. I believe empathy, either real or sincerely conveyed, speeds up healing and helps to create a collaborative doctor-patient relationship to deal with pain. So go out there a find a doctor who shows you emphathy. It may do your pain some good.
- Cheng, Y., Lin, C., Liu, H., Hsu, Y., Lim, K., Hung, D., Decety, J. (2007). Expertise Modulates the Perception of Pain in Others. Current Biology, 17(19), 1708-1713.
- Loewenstein, G. (2005). Hot-Cold Empathy Gaps and Medical Decision Making. Health Psychology. Vol 24(4, Suppl), S49-S56.
- Rakel D.P, Hoeft T.J, Barrett B.P, Chewning B.A, Craig B.M, & Niu, M. (2009). Practitioner empathy and the duration of the common cold. Family medicine, 41 (7), 494-501.
