3. Empathic Responding:
Many of the messages patients send to you involve the way they feel about their illnesses or life situations. If you are able to communicate back to a patient that you understand these feelings, then a caring, trusting relationship can be established.
Communicating that you understand another person’s feelings is a powerful way of establishing rapport and is a necessary ingredient in any helping relationship.
The importance of empathy in helping relationships has been elucidated most eloquently by psychologist Carl Rogers. Rogers developed person-centered psychotherapy, which is part of a humanistic tradition in psychology. Central is the belief that, if individuals are able to express themselves honestly in an accepting, caring atmosphere, they will naturally make healthy, self-actualizing decisions for themselves. In such an environment, people are able to reach solutions to their emotional problems that are right for them. Thus, pharmacists can be helpful by providing a “listening ear” to help patients clarify feelings. The ability to listen effectively to the emotional meaning in a patient message is the essence of empathy.
Empathy defined as the “sensitive ability and willingness to understand the client’s thoughts, feelings, and struggles from the client’s point of view . . . It means entering the private conceptual world of the other.” Empathy conveys understanding in a caring, accepting, nonjudgmental way. But when someone understands how it feels and seems to me, without wanting to analyze me or judge me, then I can blossom and grow in that climate.”
The main difference between an empathic response and a paraphrase is that empathy serves primarily as a reflection of the patient’s feelings rather than focusing on the content of the communication. The following examples, adapted from the section on paraphrasing, should illustrate the difference.
Patient #3: I don’t know about my doctor. One time I go to him and he’s as nice as he can be. The next time he’s so rude I swear I won’t go back
again.
Pharmacist #3:
Paraphrase: He seems to be very inconsistent.
Empathic Response: You must feel uncomfortable going to see him if you never know what to expect.
Patient #4: I’m so glad I moved into the retirement village. Every day there is something new to do. There are always lots of things going on—I’m never bored.
Pharmacist #4:
Paraphrase: So there are a lot of activities to choose from.
Empathic Response: You seem to love living there.
In addition to using empathic responses, two other attitudes or messages must be conveyed to the patient if trust is to be established. First, you must be genuine, or sincere, in the relationship. If the patient perceives you as phony, your “caring” a well-practiced facade, then trust will not be established. Being genuine may mean, at times, setting limits in the relationship.
For instance, it may be necessary to tell a patient that you do not have time right now to discuss an issue in detail, but will telephone or set an appointment when you are not so busy.
The fact that you were direct and honest about your limits will probably do less to harm the relationship than if you had said, “I’m listening,” while nonverbally conveying hurry or impatience.
The incongruence or discrepancy between what we say and how we act sets up barriers that are difficult to overcome.
Another essential condition is respect for and acceptance of the patient as an autonomous, worthwhile person. If you convey an ongoing positive feeling for patients, they may be more open with you since they do not fear that they are being judged. They will more likely tell you that they are having trouble taking their medications as prescribed or that they do not understand regimen directions if they know that you will not think them stupid or incompetent.
One of the biggest blocks to effective communication is our tendency to judge each other. If
we think that another will judge us negatively, we feel less willing to reveal ourselves. Acceptance and warmth, if genuine, allow patients to feel free to be more open in their communication with you.