Sympathy v. Empathy: Which Should a Therapist Have?

by Kimberly on April 14, 2009 · 11 comments

Sympathy – A relationship or an affinity between people or things in which whatever affects one correspondingly affects the other.

Empathy – Identification with and understanding of another’s situation, feelings, and motives.

from The American Heritage College Dictionary (Yes, I looked it up the old-fashioned way)

step by stepAs a therapist, music or otherwise, it is important to be aware of the difference between sympathy and empathy. It’s a subtle difference, but an important one nonetheless. Why? Because it profoundly affects how we approach and interact with our clients. We should always strive to empathize with our clients, but we should not sympathize with them. The only exception? If we have been through or are going through the same thing they are.

I was reminded of this when reading a post by a fellow music therapist, Daniel Tague, on his blog Music Makes Sense. This post introduced me to Carly, a 14-year-old girl with autism working to change the world’s perception of being around someone with autism (you can find Carly’s blog here or follow her on Twitter).

Carly is offers the world an insight into what life is like living with autism. Her blog can help the therapist, teacher, and others empathize with her label. It may help the professional approach and understand what their client is going through. But…it does not allow us to sympathize with her because we are not living her life.

I had to learn this lesson during my clinical training internship (all board-certified music therapists complete 1040 of clinical training before sitting for the national board certification exam). We facilitated a weekly substance abuse group at a 28-day treatment program. Participants in the group ranged in age from 18-75, male and female alike and from variety of socio-economic classes. I remember a particular session where a male client, a couple years older than me, opened up about the abandonment he felt and the dark places he went before reaching for the bottle. I started crying. I “felt” his pain.

After the session, a more experienced (and wiser) music therapy intern talked to me about my reaction. She helped me realize that I could never truly feel his pain (e.g. sympathize) because I have not experienced the darkness and addiction he is experiencing. But I can empathize. I can identify with him as a fellow human being with feelings and challenges. My feelings and challenges are just different than his.

Similarly, I can never sympathize with Carly. I do not have autism, nor do I have a loved one living with autism. But I can empathize with her. I can read her blog and try to have a better understanding of her experiences. I can apply this understanding when I work with my clients labeled with autism. Hopefully this will make me a better therapist for them.

Thank you, Daniel and Carly, for reminding me of this important lesson.


{ 9 comments… read them below or add one }

Roia April 14, 2009 at 6:35 pm

Thanks for making this important distinction. I think a lot of people have a hard time knowing which is most useful and under what circumstances.

The session you described (during your internship when you began to cry in response to the gentleman sharing his painful experiences) may have actually been a good example of a different kind of empathy: projective identification. Sometimes we, as music therapists, pick up the unwanted (unconscious, or unexpressed) feelings of our clients and end up expressing them.

And, yes, Carly is pretty cool. There is actually a large autistic presence on the internet. It has been tremendously helpful to me as a person who serves quite a few people on the autism spectrum who don’t use speech. It may not help me understand a specific person, but at least it gives me a good place to start!

Kimberly April 14, 2009 at 7:43 pm

Thank you, Roia, for sharing your thoughts. I agree – this is an important distinction, but it can also be a hard one to learn.

If you have any other resources you recommend, please share! I am always on the looking around for new, relevant material to read.

P.S. I checked out your blog, The Mindful Music Therapist, and have enjoyed the posts I’ve read. How funny that your most recent post mentioned “paying attention to what autistic people have to say” – people like Carly!

Roia April 15, 2009 at 7:36 pm

Two people whose books I’ve read (in bits- they’re thick books!) are Harold Searles and Patrick Casement (who wrote “Learning from the Patient” and “Learning from Our Mistakes”). Both are more analytically informed, but there’s a lot of great stuff there about using empathy and therapist reactions to understand our clients.

Thanks for swinging by my blog! Yup, I can’t imagine what sense it makes to do therapy if we don’t pay attention to our clients’ points of view, eh?

Kimberly April 16, 2009 at 5:04 pm

Thank you for the recommendations, Roia. I will add those books to my reading list!

Lindsay September 10, 2009 at 1:15 pm

Thanks Kimberly! This is very informative and something that I needed to read.


Soham August 5, 2012 at 9:15 am

Hi. I think you have it backwards. Therapists generally SYMPATHIZE with their clients. You empathize when you’d had similar experiences. You sympathize when you feel for someone.

Kimberly August 6, 2012 at 10:01 am

Hmmm…thank you for your input, but I understand it differently, especially based on the definitions at the beginning of the post. ~Kimberly

Tod L October 11, 2013 at 1:12 pm

The confusion over which term means “feeling with” arises from Carl Rogers and the dictionary being directly at odds. Rogers was the founder of “person-centered therapy”. His definitions (and corresponding advocacy of empathy) are quoted in therapeutic contexts but cause confusion with the lay person because they are reversed from common dictionary definitions. Another website offers the following Rogerian definitions in contrast to yours:
• To express sympathy is to make it known that you are aware of another’s distress and that you have compassion for them.
• To express empathy takes things a step further by not only expressing compassion but also showing a deeper level of understanding by entering into the other person’s experience.
Personally I think Carl Roger’s definitions turn the thing on its head. Entymologically “sym-pathy” means to “feel with”. Rogers advocates doing this (but calls it empathy); others I have read caution the counselor NOT to do this because it impairs his or her ability to keep emotional separation and drags the counselor into the pit with the counselee.

PARM LANIADO April 24, 2016 at 11:12 pm

In empathy you cannot violate the rule, principles and culture norms to help another person but in sympathy there are no such limits , my personal views.

Empathy is not merely an ability of humans. Many animals possess the ability to be empathetic to humans as well as other species. Empathy means that an animal understands how another animal feels without having to have the same event occur to them. For example, I can feel empathy for you if your child is injured even if my son does not suffer the same injury. I would feel sympathy if my child had the same or similar injury . . . sympathetic means I understand because it happened to me, empathetic means that I understand event though it has not happened to me. You can feel empathy for sad moments in life and you can feel empathy for happy moments.

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