When someone is going through a difficult time, it is usually empathy from another person that helps comfort them. Whether it is a lost loved one, a painful injury, or even just a frustrating situation, taking the time to put yourself in someone shoes can have profound effects on both parties.

If a patient is struggling and feels like their doctor does not care, it has the potential to build frustration and create a disconnect that can be hard to bridge. If the clinician does not pick up on the patient’s feelings it can make them seem apathetic, when a part of the issue may be they simply do not have the right tools to handle the situation.

Helen Riess, MD, is a practicing psychiatrist and researcher at Mass General. Several years ago, she began to hear rumblings among her patients regarding the lack of empathy they received from their doctors.

People felt as though clinicians were more concerned with their computer screens and number of patients seen per day than with their patient’s wellbeing.

Once the idea began making headlines, she realized how widespread the problem had become and decided to dedicate her research to empathy.

“I felt like one of the worst things that could happen is for a patient to come for help and not feel cared about.”

Helen Riess, MD

During her fellowship at Harvard, Dr. Riess focused on the neuroscience of empathy to understand the fundamentals of how people connect and the true meaning of empathy. It was then that she realized empathy was not just an emotional response, but a cognitive one as well, and if that was the case, there was a chance she could teach it.

The Study of Teaching Empathy

In 2010, Reiss and a team of researchers conducted a pilot study with 15 otolaryngology residents at Mass Eye and Ear. The residents participated in a 6-8 week empathy training and were evaluated by patients pre- and post-training, along with other residents who did not receive empathy training. All residents who received the training had significantly improved patient ratings after the 6-8 weeks.

She recreated the study a year later with 100 Mass General residents. After empathy training, all residents received increased ratings from their patients, while those who did not receive training showed no improvement.

These results were groundbreaking because empathy was generally seen as a quality a person either has or does not have—not something that can be taught. The studies that showed it is possible to teach and practice empathy, so long as you have the right tools.

“We can all get very focused on the outcomes we find most important, but maybe we forget that there are other concerns going on, not just pain, but what’s going on in the person’s life.”

Helen Riess, MD

The Building Blocks of Empathy

The training was broken down into several components to give clinicians a comprehensive understanding of the complexities of empathy. One component involves nonverbal cues and the different ways people can perceive the emotions of others. Clinicians were trained to decode facial expressions and understand the nonverbal ways people respond to emotion.

Participants were also taught to practice mindfulness. The training provided strategies to help clinicians stay grounded, let distracting thoughts go, and how to effectively compartmentalize patient experiences so that emotions from one interaction do not boil over another.

Dr. Riess’ experience as a psychiatrist also compelled her to include training on how to look for psychiatric symptoms that could contribute to making relationships difficult, so clinicians could better understand and empathize with a patient’s situation or provide a referral, if necessary.

The Empathy Effect

After word of the empathy training spread, the requests for training began to flood in. The training was initially created for people in the health professions, but Riess started to receive requests from leaders in a variety of fields, such as business, education, parenting and more.

Incorporating empathy into a variety of fields was gaining momentum because of the concept’s translatability, as well as Riess’ research that showed it could be taught. This influx of interest was part of the impetus for writing her first book: The Empathy Effect.

The book aims to help readers from all walks of life and professions understand the importance of empathy and the neuroscience research behind it. Using her findings, she created a curriculum and toolkit to build empathetic skills to foster meaningful relationships of any kind.

“The biggest shift is moving out of our own heads and really being interested in what other people are saying. Active listening is probably one of the hardest skills that anybody has to deal with because we are all busy with chatter in our own minds and to-do lists. So the gift of really listening with true curiosity about someone, when you do that, you can really develop deep and meaningful relationships.”

Helen Riess, MD

As Dr. Riess continues her research, she hopes to find more ways to incorporate empathy into everyday life. Through her book, teaching and speaking, she aims to keep raising awareness surrounding the importance of genuine caring, and to encourage people that they can make a difference.

About the Mass General Research Institute
Research at Massachusetts General Hospital is interwoven through more than 30 different departments, centers and institutes. Our research includes fundamental, lab-based science; clinical trials to test new drugs, devices and diagnostic tools; and community and population-based research to improve health outcomes across populations and eliminate disparities in care.
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