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- Jumping in too quickly—You should avoid interrupting patients (unless their ver-
bosity is hindering the accomplishment of session goals) or thinking you must
respond immediately after they speak. - Using inappropriate language—Jargon or words that are too complicated can
distance patients. Try to match your patient’s language level. - Forgetting to use silence—Silence and a calm presence can be as empathic as
anything you might say. Silence allows patients to become aware of their feel-
ings, digest what has been discussed, and collect their thoughts (see Chap. 3
section on silence). - Not allowing enough time for patients to respond to your empathy statements—
Silence often seems much longer to a beginning counselor than it actually is. Try
mentally counting to 10 or 15 before jumping in; by then, most patients will have
responded to your statement. Of course, when patients cannot think of how to say
what they want to express (watch for nonverbal indications of this), you can step
in with a statement like “It’s hard to put into words what you want to say” or
“What do you think about what I just said?” - Taking sides—Expressing a lot of empathy for one member of a couple or for
certain family members and forgetting to do so with the other individuals is divi-
sive and judgmental on your part. - Forgetting the cultural context—As mentioned earlier, empathy can be conveyed
quite differently in some populations. Clinicians must recognize the validity of
cultural variation, in addition to overarching human commonalities and within
group variation (Chung and Bemak 2002 ; Salzman 1995 ).
4.9 Typical Concerns About Primary Empathy
Beginning genetic counselors typically have a number of concerns about empathy.
In the following sections, we address some common questions.
4.9.1 Why Is Empathy Sometimes Difficult?
Many patients will experience intense, unpleasant emotions. It is a natural human
tendency to want to feel pleasant emotions and avoid unpleasant ones. So, patients
may avoid expressing and/or acknowledging their unpleasant feelings. Similarly,
we may avoid empathizing because we are afraid of feeling our patients’ pain.
Reflecting feelings is challenging because “In our culture [U.S.] we learn to
comfort people by encouraging them to run away from their feelings. We are taught
to say, ‘Don’t cry, it’ll be all right,’ when it quite probably won’t be all right and the
person really needs to cry to release his emotional pain” (Geldard and Anderson
1989 , p. 37). Although directly confronting feelings may be uncomfortable for your
patients and for you, it is sometimes essential because “At crisis times in our lives
4 Listening to Patients: Primary Empathy Skills